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目的探讨四肢骨软骨瘤的临床常见并发症及手术治疗方法。方法回顾性分析我院从2002年至2010年收治的40例出现临床并发症的四肢骨软骨瘤,主要并发症包括:血管、神经损伤,关节畸形,恶变。患者中,男性24例,女性16例,年龄5～66岁(平均24.6岁)。所有患者均行术前X线及CT检查;均行手术治疗,24例行单纯肿瘤切除,3例行肿瘤切除自体髂骨移植,2例行肿瘤切除上胫腓关节重建,4例行肿瘤切除尺桡骨Ilizarov外固定延长术,4例因发生恶变行截肢术。结果所有病例得到随访,随访4-24个月(平均随访16.7个月),2例患者出现复发,总体复发率5%,其余患者原有神经受压症状消失,前臂短缩畸形得到纠正,肢体功能满意。结论骨软骨瘤并发症临床较少见,表现特殊,极大影响四肢的功能。手术能去除或缓解并发症,术中注意相邻组织的保护,保持或重建邻近关节的稳定性,特别是对于青少年。
Objective To investigate the common clinical complications and surgical treatment of osteochondral tumors of the extremities. Methods Retrospective analysis of 40 cases with clinical complications of limb osteochondroma treated in our hospital from 2002 to 2010 were retrospectively analyzed. The main complications include: vascular, nerve injury, joint deformity and malignant transformation. Among the patients, 24 were males and 16 were females, aged 5 to 66 years (mean, 24.6 years). All patients underwent preoperative X-ray and CT examination. All the patients underwent surgical resection. Twenty-four patients underwent simple tumor resection, three patients underwent resection of autologous iliac bone graft, two patients underwent resection of the tibiofibular joint, and four patients underwent tumor resection Ilizarov external fixation of ulna and radius, and 4 cases of amputation due to malignant transformation. Results All cases were followed up for 4-24 months (mean follow-up of 16.7 months). Two patients developed recurrence with an overall recurrence rate of 5%. The rest of the patients had no symptoms of original nerve compression and the forearm shortening deformity was corrected. Functional satisfaction. Conclusion The clinical manifestations of osteochondroma are rare, with special features that greatly affect the function of the limbs. Surgery can remove or alleviate complications, pay attention to the protection of adjacent tissues, maintain or rebuild the stability of the adjacent joints, especially for adolescents.