PDF(Pubmed)
Abstract：
Reconstruction options for giant cell tumors (GCTs) of bone are limited and challenging due to the amount of structural compromise and the high recurrence rates. This is especially true for GCTs of the foot and ankle, as the area is vital for weight bearing and function. The typical treatment for GCTs is currently excision, curettage, and cementation, although that is not always effective. A 36-year-old otherwise healthy female presented with an original diagnosis of a large aneurysmal bone cyst (ABC) of the distal tibia that had recurred despite two previous attempts at treatment with resection and cementation. She was treated with surgical resection of the lesion, reconstruction, and ankle and subtalar joint arthrodesis with a tibiotalocalcaneal intramedullary nail in combination with a trabecular metal cone. The final pathology of the intraoperative samples was consistent with GCT. Postoperatively, she recovered well, and her imaging was consistent with a successful fusion. This case report provides evidence that tibiotalocalcaneal fusion with a unique combination of hindfoot nail and trabecular metal cone construct in a single procedure is a successful option for the treatment of large, recurrent GCT lesions in the distal tibia.
摘要：
骨巨细胞瘤（GCT）的重建选择是有限的和具有挑战性的，由于结构损害的数量和高复发率。对于脚和脚踝的GCT尤其如此，因为该区域对承重和功能至关重要。目前GCT的典型治疗方法是切除，刮宫,和胶结，虽然这并不总是有效的。一名36岁的健康女性，最初诊断为胫骨远端大动脉瘤性骨囊肿（ABC），尽管先前曾两次尝试切除和骨水泥治疗，但仍复发。她接受了手术切除病灶的治疗，重建,以及踝关节和距下关节的关节固定术，使用胫骨骨髓内钉和小梁金属锥。术中标本的最终病理与GCT一致。术后,她恢复得很好,她的成像与成功的融合一致。此病例报告提供了证据，表明在一次手术中使用后足指甲和小梁金属锥结构的独特组合进行胫骨骨融合是治疗大型，胫骨远端复发性GCT病变。
