【摘要】 目的 回顾分析 19 例距骨软骨母细胞瘤病例临床特点，更好的阐述距骨软骨母细胞瘤的临床表现、手术治疗方法及预后。方法 2007 年 1 月至 2020 年 12 月，经治距骨软骨母细胞瘤病例 19 例。所有患者的性别、年龄、病程、影像均进行复习并分析记录。患者的骨破坏形式按 Lodwick 分型进行划分。术后定期随访患者的肿瘤学和功能学结果，功能结果用骨骼肌肉系统肿瘤协会 (musculoskeletal tumor society，MSTS) 评分进行评价。结果 本组 19 例，男 14 例，女 5 例，年龄 10～34 岁，平均 21 岁，病程 1～24 个月，平均 10.9 个月。3 例累及距骨头颈部，15 例累及体部，1 例累及整个距骨。X 线按 Lodwick 分型进行划分，11 例为 ⅠA，8 例为 ⅠB。所有患者均进行扩大刮除及氩气刀灭活。刮除后的空腔，6 例行人工骨填充，7 例行骨水泥填充，4 例行同种异体骨填充，1 例行自体骨填充，1 例关节面下行自体骨填充，其余空腔用骨水泥填充。16 例随访 34～193 个月，中位随访时间 94 个月；3 例失访。无复发及转移。异体骨填充组植骨愈合时间 8～14 个月，平均 10.8 个月，人工骨填充组愈合时间 6～12 个月，平均 9.7 个月，1 例行自体骨填充，术后 6 个月愈合，1 例关节面下行自体骨填充，其余空腔用骨水泥填充，植骨愈合时间为 12 个月。所有患者的 MSTS 评分 29～30 分，平均 29.6 分，各填充材料组患者的术后功能差异无统计学意义 (P=0.753)。结论 距骨软骨母细胞瘤常见。扩大刮除术是合适的治疗方法，瘤腔的填充材料对患者术后功能影响差异无统计学意义。足够的刮除范围，术后合理的康复，患者均可获得较好的肿瘤学及功能学结果。更多还原

【Abstract】 Objective A retrospective analysis of the clinical characteristics of 19 cases of chondroblastoma of the talus,in order to better elucidate the clinical manifestations,surgical treatment and prognosis of chondroblastoma of the talus.Methods From January 2007 to December 2020,19 cases of chondroblastoma of the talus were treated.All patients’ gender,age,course of disease,and imaging were reviewed and analyzed.The bone destruction was classified according to Lodwick classification.Oncology and functional results were regularly followed up after surgery,and functional results were evaluated using the MSTS score.Results There were 19 cases including 14 males and5 females.The mean age was 21 years (range:10-34 years).The average course of disease of 10.9 months (range:1-24 months).The head and neck of the talus were affected in 3 cases,the body in 15 cases and entire talus in 1 case.X-ray was classified according to Lodwick classification,with 11 patients as ⅠA and 8 patients as ⅠB.All patients underwent extensive curettage and argon knife inactivation.The cavity was filled with artificial bone in 6 patients,cement in 7 patients,allogeneic bone in 4 patients,autograft in 1 patient,autograft and cementin in the remaining patient.16 cases were followed up for more than 2 years,and 3 cases were lost.The patients who were followed up had a median follow-up time of 94 months (range:34-193 months).No recurrence or metastasis was observed.The healing time of the allograft bone filling group was 10.8 months (range:8-14 months),while the artificial bone filling group was 9.7 months (range:6-12 months).One case received autograft filling,and healed 6 months after surgery.One case received autograft filling under the joint surface,and the remaining cavities were filled with bone cement.The healing time of the bone grafting was 12 months.The average MSTS score of all patients was 29.6 (range:29-30).There was no significant difference in postoperative function among the different filling material groups (P=0.753).Conclusions Chondroblastoma of the talus is common.Expanded curettage is an appropriate treatment method.The filling material of the tumor cavity has no significant impact on postoperative function of patients.Adequate extensive curettage and reasonable postoperative rehabilitation can bring better oncological and functional outcomes for patients.更多还原