TOPUK AĞRISININ NADİR BİR NEDENİ, KALKANEUS YERLEŞİMLİ İNTRAOSSEÖZ LİPOM: 9 OLGUNUN RETROSPEKTİF ANALİZİ ve LİTERATÜR DERLEMESİ

Amaç: İntrakalkaneal lipom nadir görülür ve sıklıkla asemptomatiktir. Semptomatik olan vakalarda ise çoğunlukla ilk ve en sık şikâyet basit topuk ağrısıdır. Bu çalışmanın amacı, topuk ağrısı sebebiyle başvurdukları kliniklerde çeşitli ön tanılar alarak cerrahi dışı yöntemler ile tedavi edilmeye çalışılan ve kliniğimizde cerrahi olarak başarıyla tedavi edilmiş 9 olgunun retrospektif analizini ve literatür derlemesini sunmaktır.Gereç ve Yöntem: Kliniğimizde 2008 ve 2015 yılları arasında intrakalkaneal lipom tanısı ile ameliyat edilen 9 hasta (4 kadın, 5 erkek) çalışmaya dahi edildi. Ortalama yaş 40,6 (19-70) yıl idi. Ortalama takip süresi 50,4 (12-114) ay idi. Başlangıçtaki yanlış tanı ile gerçek tanı arasındaki süre 20,8 (12-48) ay idi. Hastalar kliniğimize başvurmadan önce, Achilles tendiniti, epin kalkanei, retrokalkaneal bursit ve plantar fasiit tanıları almış ve tedavi edilmeye çalışılmıştır. Bulgular: Yedi hasta küretaj & kemik grefti ve 2 hasta küretaj & kemik sementi ile tedavi edildi. Tüm hastalar ortalama 5 (3-11) ayda tamamen ağrısız iyileşti. Kemik greftlerinin tam olarak konsolidasyonu ortalama 6 (5-9) ayda görüldü. Ortalama AOFAS skoru ameliyat öncesi 80,4 ten birinci yılda 95,3’e yükseldi. Sonuç: Topuk ağrısı olan hastalarda intrakalkaneal lipom ayırıcı tanıda düşünülmelidir. Küretaj ve kemik grefti ile grefonaj ağrılı ve kritik boyutta intrakalkaneal lipomlar için iyi bir cerrahi tedavi seçeneği olabilir.Anahtar kelimeler: Topuk ağrısı; kemik içi lipomlar; kalkaneus.

Anahtar Kelimeler:

Topuk ağrısı, kemik içi lipomlar, kalkaneus

A RARE CAUSE OF THE HEEL PAIN: INTRAOSSEOUS LIPOMA OF THE CALCANEUS: A REVIEW OF LITERATURE AND RETROSPECTIVE ANALYSIS OF 9 CASES

Objective: Intracalcaneal lipoma is a rare disease and frequently asymptomatic. Usually the first and the most common complaint is simple heel pain in symptomatic cases. The purpose of this study is to present a literature review and retrospective analysis of 9 cases with intracalcaneal lipoma whose various preliminary diagnosis varied in other clinics due to heel pain. Material and Methods: Between 2008 and 2015, 9 patients (4 females and 5 males) with intracalcaneal lipoma were operated in our institution. The mean age of the patients was 40.6 (19-70) years. The mean follow-up was 50,4 (12-114) months. The time between initial misdiagnosis and confirmed diagnosis was 20.8 (12-48) months. The patients were treated as misdiagnosed with Achilles tendinitis, epin calcanei, retrocalcaneal bursitis and plantar fasciitis before admission to our clinic. Results: Seven patients were treated with curratage & bone grafting and 2 patients with curettage & bone cementing. All patients recovered without heel pain in the mean 5 (3-11) months. Complete consolidation of the bone graft was seen at the mean 6 (5-9) month. The mean AOFAS score was increased from 80.4 preoperatively to 95.3 at the first year.Conclusion: Intracalcaneal lipoma should be considered in the differential diagnosis of the patients with heel pain. Curettage and bone grafting can be a good surgical option for the treatment of painful and critically sized intracalcaneal lipomas.Keywords: Heel pain; intraosseous lipoma; calcaneus.

Keywords:

Heel pain, intraosseous lipoma, calcaneus,

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1. Milgram J.W., Intraosseous lipomas: A clinicopathologic study of 66 cases. Clin Orthop Relat Res 1988; 231: 277-302.
2. Futani H, Fukunaga S, Nishio S, Yagi M, Yoshiya S. Successful treatment of bilateral calcaneal intraosseous lipomas using endoscopically assisted tumor resection. Anticancer Res 2007;27(6): 4311-4. 3. Narang S, Gangopadhyay M. Calcaneal intraosseous lipoma: A case report and review of the literature. J Foot Ankle Surg 2011;50(2): 216-20.
4. Bertram C, Popken F, Rütt J. Intraosseous lipoma of the calcaneus. Langenbeck's Arch Surg 2001; 386(5): 313-7.
5. Bagatur AE, Yalcinkaya M, Dogan A, Gur S, Mumcuoglu E, Albayrak M. Surgery is not always necessary in intraosseous lipoma. Orthopedics 2010;33(5): 306
6. Blacksin, MF, Ende N, Benevenia J. Magnetic resonance imaging of intraosseous lipomas: A radiologic-pathologic correlation. Skeletal Radiol 1995;24(1): 37-41.
7. Coquerelle P, Cotten A, Flipo RM, Chastanet P, Duquesnoy B, Delcambre B. Intraosseous lipoma: role and limitations of modern imaging techniques. Rev Rhum Engl Ed. 1995;62(2): 147-50.
8. Goto T. et al., Intraosseous lipoma: a clinical study of 12 patients. J Orthop Sci 2002; 7(2): 274-80.
9. Hirata M, Kusuzaki K, Hirasawa Y. Eleven cases of intraosseous lipoma of the calcaneus. Anticancer Res 2000; 21(6A): 4099-103.
10. Hong J, et al., Titanium is a highly thrombogenic biomaterial: possible implications for osteogenesis. Thromb Haemost 1999; 82(1): 58-64.
11. Huch K, Werner M, Puhl W, Delling G.Calcaneal cyst: a classical simple bone cyst? Z Orthop Ihre Grenzgeb 2003; 142(5): 625-30.
12. Pappas AJ, Haffner KE, Mendicino SS.Haffner, and S.S. Mendicino, An intraosseous lipoma of the calcaneus: a case report. J Foot Ankle Surg, 2014. 53(5): p. 638-642.
13. Saraph V, Zwick EB, Maizen C, Schneider F, Linhart WE. Treatment of unicameral calcaneal bone cysts in children: review of literature and results using a cannulated screw for continuous decompression of the cyst. J Pedatr Ortoph 2004; 24(5): 568-73.
14. Schneider O, Mischo J, Püschel W. Intraosseous lipoma of the calcaneus. Chirurg 1994;65(1):74–6.
15. Weinfeld GD, Yu GV, Good JJ. Intraosseous lipoma of the calcaneus: a review and report of four cases. J Foot Ankle Surg 2002; 41(6):398-411.
16. Hassani M, Gharehdaghi M, MD, Khooei AR, Ghodsi E, Nazarzadeh H. Bilateral Intraosseous Tumor of the Calcaneus with Imaging-Pathologic Discordance A Case Report and Literatures Review. Arch Bone Jt Surg 2014; 2(3):238.
17. UK Krishnan, Inwards CY. Dahlin's bone tumors: general aspects and data on 10,165 cases. Lippincott Williams & Wilkins, 60. Ed. 2010; 295-304.
18. Ulucay C, Altintas F, Ozkan NK, Inan M, Ugutmen E. Surgical treatment for calcaneal intraosseous lipomas. Foot 2009; 19(2):93-7.
19. Aumar DK, Dadjo YB, Chagar B. Intraosseous Lipoma of the Calcaneus: Report of a Case and Review of the Literature. J Foot Ankle Surg 2013; 52(3): 360-3.
20. Chow LT, Lee KC. Intraosseous Lipoma: A Clinicopathologic Study of Nine Cases. Am J Surg Pathol 1992;16(4): 401-10.
21. Pogoda P, et al., Clinical relevance of calcaneal bone cysts: a study of 50 cysts in 47 patients. Clin Orthop Relat Res 2004; 424: 202-10.
22. Radl R, et al., Intraosseous lipoma: retrospective analysis of 29 patients. Int Orthop 2004; 28(6): 374-8.