骨软骨瘤骨折10例

骨软骨瘤临床常见 ,但骨软骨瘤骨折却鲜见报道。笔者自 1986年 7月至今共诊治骨软骨瘤 380例 ,其中 10例发生骨软骨瘤骨折。1　临床资料本组男 8例 ,女 2例。年龄 :9～ 14岁 9例 ,30岁 1例。骨软骨瘤骨折发生部位 :肱骨上端 1例 ,股骨内髁 3例 ,股骨外髁 1例 ,胫骨上端内侧 5例。有局部直接外伤史者 2例 ,有剧烈运动史者 6例 ,有长期快速行走史者 2例。所有病例均表现为患处突然疼痛、肿胀 ,进行性加重。局部可闻及骨擦音者 6例 ,局部抽出不凝血者 8例。所有发生骨折的骨软骨瘤均具有细而长的茎或茎短粗但顶端膨大的特点。Ｘ线确诊6例 ,ＣＴ…     

腓骨上端骨软骨瘤致血管神经受压误诊1例

中国图书资料分类法分类号Ｒ７３８．１１病例资料患者，男，１９岁。６年前始出现左膝关节疼痛。曾在外院就诊，以“良性关节痛”、“关节炎”对症治疗。１年来左小腿酸胀痛，易疲劳，左足底麻木。外院摄左膝关节Ｘ线片未见异常（拍片范围过小）。因入院前１月症状明显加...     

下胫腓联合骨软骨瘤致腓骨自发性骨折1例报告

患者,男,65岁,2005年2月中旬无明显外伤史,因左踝关节疼痛2h入院。检查：左外踝轻度肿胀,局部张力不高,无软组织挫伤与瘀血斑,无皮肤发红、发热等炎性改变。踝关节活动时腓骨下端疼痛,且该处有明显压痛,纵向叩击痛阳性。趾端血运良好，足背和胫后动脉搏动正常。血沉18mm／h，碱性磷酸酶3．5U（布氏法），酸性磷酸酶1．0U（布氏法）。     

甲下骨疣误诊为嵌甲症1例

1 病例资料 患者,男, 30岁.因穿鞋右拇趾末端疼痛,甲沟局部反复感染2年内行5次拔甲,趾甲成形1次均无效来诊.患者右拇趾末端肿胀,趾甲畸形,甲下局部隆起变形,甲床增厚,局部压痛,甲下脓性分泌物.X线摄片发现末节趾骨甲下骨性突起病变,边界清楚,骨突的基底较宽与趾骨皮质相连续,诊断为甲下骨疣.见图1.     

股骨颈骨软骨瘤致梨状肌综合征1例报告

患者 ,男 ,2 6岁。入院前 1年无明显诱因出现右臀后部及右股后侧疼痛 ,未经治疗。后疼痛逐渐加重 ,并沿右股后侧放射至右小腿及足底 ,伴右小腿后外侧及足部皮肤麻木。入院查体 :腰椎呈生理弯曲 ,活动自如 ,无压痛和叩痛。无椎旁压痛及放射痛。右直腿抬高 70°( )。右髋关节活动略受限 ,右髋关节内收及内旋时出现右下肢放射痛。右髋关节后方可触及 5× 6ｃｍ2 大小硬性肿物 ,位置固定 ,可随右髋关节活动而移动。肿物表面可触及横行条索状物 ,质中等 ,压痛 ( )。右小腿后外侧及足部皮肤痛觉减退。右跟腱反射减弱。病理反射未引出。Ｘ线片 :…     

骨软骨瘤并假性动脉瘤1例

<正>患者,男,19岁。因"左大腿疼痛4个月"于2012年4月21日入我院就诊。患者于4个月前无明显诱因出现左大腿远端疼痛,休息后可稍缓解,不伴红肿、发热不适。后逐渐出现左小腿麻木,无多发性骨软骨瘤病史及家族史,无外伤史。入院后查体:左腘窝上方有一明显软组织包块,边界欠清,约鹅蛋大小,质韧,活动度差,局部皮温较高,听诊有清晰粗糙杂音。术前X线片示:左股骨下段内后侧可见一骨性突起,背关节面生长,左腘窝上骨性突起的后方见一卵圆形软组织块     

腰椎管内骨软骨瘤例1例

骨软骨瘤是临床常见的良性骨肿瘤之一,好发于四肢长骨干骺端．发生在脊柱者少见。脊柱骨软骨瘤因病变部位隐蔽,临床表现不典型．诊断比较困难,容易误诊．笔者于2006年10月收治1例脊住骨软骨瘤患者．报道如下     

距骨巨大骨软骨瘤致足背血管危象1例

1病例资料患者,女,80岁。左踝前内侧包块10余年逐渐增大1年,剧烈疼痛伴足拇趾暗红、麻木4d入院。10年前,无意中发现左踝关节前肿块、无疼痛,因不影响关节功能,一直未治疗。1年前肿块增大至4·5cm×2·5cm×3×0cm大小,同时感踝前可忍耐疼痛,行走后加重。当地医院给予“消炎止痛     

单发性骨软骨瘤瘤体骨折2例报告

单发性骨软骨瘤是一种良性骨肿瘤，临床因大多数症状不典型而少见。本院近2年共收治2例，均因瘤体骨折而人院，并经病理证实，现报告如下。     

骨软骨瘤致骨关节畸形7例诊治分析

目的：总结7例骨软骨瘤致骨与关节畸形病例的诊治经验。方法：所有患者均行X线检查，其中2例行CT检查；均行手术治疗，1例行单纯肿瘤切除，1例行肿瘤切除、下胫腓关节融合，2例行肿瘤切除、尺桡关节重建，3例行瘤骨段切除。结果：随访12～24个月，无复发。除桡骨近端切除者关节功能欠佳外，余者功能良好。结论：发生于解剖关系密切的两个相邻骨之间骨软骨瘤患者，表现特殊，一经确诊，应尽早手术，术中注意保持或修复关节的稳定性，保留良好的功能。     

腓下骨误诊为骨折块1例

患者,女,43岁,于2002年2月6日下楼梯时不慎踏空跌倒,左足内翻扭伤,即感左踝疼痛,行走不便。第2天局部肿痛更加明显,站立行走均困难。查体:左外踝瘀肿明显,压痛,左踝关节屈伸、内外翻均受限。左踝X线正位片示:外踝尖下有0·5 cm×0·5 cm的小骨块,与外踝尖部分重叠;侧位片示:外踝前缘有0·5 cm×0·5 cm的骨块影。入院诊断为左外踝撕脱性骨折,考虑到撕脱的小骨折块,有可能位于外踝尖与距骨之间的关节腔内,日后有可能影响踝关节的屈伸功能,在征得患者及家属的同意后,决定手术摘除小骨块。于2月7日下午在腰麻下作左外踝撕脱骨块摘除术,行左外…     

Solitary osteochondroma of the trapezium: case report

Osteochondroma of the carpal is rare. We found only 1 case of osteochondroma of the trapezium in the literature. We present a case of a 52-year-old woman with an osteochondroma of the left trapezium and trapeziometacarpal arthritis.     

极易误诊为胫骨平台外侧撕脱性骨折1例

<正>患者,男,58岁,主因左膝部肿痛伴活动不利2 d于2016年7月10日入院。患者2 d前不慎摔倒致左膝部内翻及内旋,出现左膝部肿痛伴活动不利,当时无胸闷气急,无恶心呕吐,无头痛头晕。随即由家人送至当地医院诊治,拍摄X线片示左胫骨平台外侧撕脱性骨折,予以患肢过膝长腿石膏固定。为求进一步治疗,转入我院就诊,门诊以"左胫骨平台外侧撕脱性骨折"收住院。患者既往体健,无高血压、糖     

Paraarticular osteochondroma of talocalcaneal joint: a case report

An 18-year-old male presented with a swelling in the posterior aspect of the right ankle since 2 years and recent onset of pain on walking. Physical examination and Roentgenography revealed a distinct osseous lesion in the posterior aspect of the talocalcaneal joint. During surgical excision, the lesion was separate from the talus and the calcaneum and appeared to originate from the capsule of the talocalcaneal joint. Histology revealed a benign osteochondroma. The talocalcaneal joint is a very rare site for the origin of osteochondroma. From literature review, it appears that this is the first reported case of a paraarticular osteochondroma arising from the talocalcaneal joint.     

锁骨旁脂肪瘤骨化误诊为骨软骨瘤1例

正患者,男,40岁,右锁骨区肿块20余年来院就诊。患者20多年前无意间触及右锁骨区有一蚕豆大小的肿块,质软,无明显疼痛,活动颈部亦无明显疼痛,无右上肢麻木不适,无头痛头晕,无胸闷气促,无畏寒发热,皮肤完整,未发现局部肿胀及溃疡,无明显疼痛不适。因未向皮肤表面凸起,故20年来未曾就诊,肿块缓慢增大,无其他明显不适,约桃核大小,     

Calcaneal osteochondroma masquerading as plantar fasciitis: An approach to plantar heel pain-A case report and literature review

BACKGROUND Heel pain is a common orthopaedic complaint, and if left untreated can be a source of chronic morbidity. Accurate diagnosis can be challenging, owing to the complex anatomy and multiple pain generators present in the foot. We aim to share our clinical experience managing an unusual case of chronic heel pain secondary to osteochondroma.CASE SUMMARY A 41-year-old obese male who works as a porter presented with a long-standing history of left plantar heel pain. He was assessed to have point tenderness over the plantar insertion of the calcaneus as well as a positive Silfverski?ld test. He was treated for plantar fasciitis and tight gastrocnemius but failed conservative therapies as well as surgical intervention. Magnetic resonance imaging revealed the presence of a pedunculated bony protrusion over the plantar aspect of the calcaneus. The decision was made for excision of the osteochondroma, and the patient has been pain-free since.CONCLUSION Osteochondromas are rarely symptomatic in skeletally mature patients. While most are benign with a very low risk of malignant transformation, surgical excision can yield excellent results and significant pain relief in symptomatic patients.     

Dedifferentiated chondrosarcoma arising in a solitary osteochondroma with leiomyosarcomatous component: a case report

BACKGROUND: A rare variant of dedifferentiated chondrosarcoma with leiomyosarcomatous component in a 63-year-old male is reported. CASE REPORT: He had a life-long osteochondroma adjacent to the left knee and recently developed swollen and pain. We initially suspected an intermediate grade chondrosarcoma arising in a solitary osteochondroma, but a biopsy specimen revealed a dedifferentiated component that histologically was classified as leiomyosarcoma. Multiple lung metastases were also present. The patient underwent amputation above knee and lung operation following adjuvant chemotherapy, but he died because of pulmonary metastasis 2 years after first admission. DISCUSSION: The differentiated component usually shows the histological features of osteosarcoma, malignant fibrous histiocytoma, and fibrosarcoma. Among the rare dedifferentiation with leiomyosarcomatous component, case arising in a solitary osteochondroma is not reported yet.