Müjdat ADAŞ, H.Cihangir YURDOĞLU, Murat TONBUL, Mehmet Uğur ÖZBAYDAR, İlker KERİŞ

Femur alt uç enkondromlarının küretaj ve kemik çimentosu ile tedavi sonuçları

Amaç: Femur alt ucunda saptanan enkondrom nedeniyle küretaj ve kemik çimentosu ile tedavi edilen hastalar değerlendirildi. Çalışma planı: Çalışmaya femur alt uçta enkondrom tanısıyla cerrahi tedavi uygulanan 13 hasta (7 kadın, 6 erkek; ort. yaş 54; dağılım 43-65 yaş) alındı. On hastada lezyon, tesadüfen saptandı; bunların yedisinde ağrı yakınmaları sonradan ortaya çıktı. Ameliyatta, lezyona küretaj uygulanarak oluşan boşluk kemik çimentosuyla dolduruldu. Yedi hastaya ameliyat öncesinde biyopsi yapıldı. Klinik değerlendirmede görsel ağrı skalasından yararlanıldı. Ortalama takip süresi dört yıl (dağılım 1-5 yıl) idi. Sonuçlar: Radyografilerde lezyonların ortalama boyutu 4.5 cm (dağılım 3-6 cm) ölçüldü. Bilgisayarlı tomografide, lezyonlardan beşinin kortekse doğru genişlediği, birinde de arka kortekste incelmeye neden olan erozyon oluşturduğu görüldü. Ameliyat öncesinde ortalama 3.63 (dağılım 0-7) olan ağrı skoru son kontrollerde 0.54’e (dağılım 0-3) düştü (p

Anahtar Kelimeler:

Tıbbi kayıtlar, Femoral neoplazmlar, Tedavi sonucu, Kemik çimentosu, Kondrom, Küretaj, Geriyedönük çalışma

The results of curettage and bone cementing for enchondromas of the distal femur

Objectives: We evaluated patients who were treated with curettage and cementing for enchondromas localized in the distal femur. Methods: The study included 13 patients (7 females, 6 males; mean age 54 years; range 43 to 65 years) who underwent surgery for enchondromatosis in the distal femur. Enchondromas were detected incidentally in 10 patients; of these, complaints of pain appeared afterwards in seven patients. Surgery involved curettage and cement filling of the defects. Preoperative biopsies were obtained in seven patients. Clinical evaluations were made with a visual analog scale. The mean follow-up period was four years (range 1 to 5 years). Results: Radiographically, the size of the lesions ranged from 3 cm to 6 cm (mean 4.5 cm). Computed tomography showed cortical extension in five patients and erosion leading to narrowing in the posterior cortex in one patient. The mean pain score decreased from 3.63 (range 0 to 7) to 0.54 (range 0 to 3) postoperatively (p<0.05). Histopathological diagnoses of surgical specimens were enchondroma in 12 patients and grade 1 chondrosarcoma in one patient. Postoperatively, only one patient who had erosion and narrowing in the posterior cortex required cast immobilization for three weeks. None of the patients had recurrence, sarcomatous changes, or infection. No functional loss developed after surgical treatment. Conclusion: Treatment of femoral enchondromas with curettage and cementing yields successful functional and radiologic results.

Keywords:

Medical Records, Femoral Neoplasms, Treatment Outcome, Bone Cements, Chondroma, Curettage, Retrospective Studies,

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