enchondroma curettage bone grafting

Isolated endogenous chondroma is a relatively common tumor, mainly found in long tubular bones and short tubular bones on the limbs. As the tumor grows, the bone of the affected bone becomes thinner and swells. This condition is more common in the phalanx, metacarpal or metatarsal. Isolated endogenous chondromas can be converted to chondrosarcoma, but this malignant transformation is more common in chondromas in long tubular bones, while few in short tubular bones have malignant changes. Treatment of diseases: chondroblast osteochondroma Indication Suitable for patients with endogenous chondroma. Preoperative preparation The site of avascular necrosis of the femoral head must be identified before surgery. That is to say, the necrotic lesion is partial or posterior, partial or partial. It can be seen at a glance through CT. This determines the surgical approach, otherwise it will be difficult to reach the lesion area accurately when the lesion is removed. If the lesion is located in the anterior medial aspect of the femoral head, the anterior and posterior approach of the hip should be used as the Smith-petersen incision. If the lesion is located in the posterolateral aspect, the posterior approach of the hip should be used as the Gibson incision. After exposing the hip joint, the switch capsule is cut so as to fully expose the head and neck and achieve the decompression effect in the joint capsule. Open the window at the junction of the head and neck, the diameter is about 1.0 ~ 1.5cm, then use the curette to pass through the hole to completely scrape the necrotic tissue, if necessary, the electric drill or hand drill can be inserted through the tunnel, directly to the subchondral bone, so, The distal intramedullary blood vessels can grow into the periphery of the necrotic area. Finally, the removed autologous tibia is cut into small pieces to fill the scraped cavity and tunnel. The main role of bone grafting is to provide a strong support for the collapsed femoral head to return to its normal shape, thus avoiding fracture complications. During the operation, attention should be paid to the protection of the femoral head cartilage to avoid scratches caused by the instrument. When implanting bone, it is necessary to prevent the bone from falling into the joint capsule and causing the loose body, which affects the joint function. When suturing the joint capsule, it should not be too tight, and a certain gap should be left to achieve the purpose of continuous decompression in the joint capsule. Surgical procedure A mid-miple middle phalanx fracture occurred in the middle middle finger when working 6 weeks ago. The diagnostic radiograph of X-ray film was diagnosed as "endocardial chondroma pathological fracture". Gypsum brake for 6 weeks. The X-ray film shows that there is a density-reduced area in the remote part of the phalanx, which is in the form of frosted glass with scattered calcification points. Cut the skin, reveal the middle phalanx, use a bone knife to open the window at the lesion, and remove the bone piece when the window is opened. The contents are glassy cartilage tissue. Carefully scrape the contents and use a small spoon to scrape the uneven wall. Soak the tumor cavity with 95% alcohol for 5 minutes. The cortical bone and cancellous bone were taken and cut into granules to fill the tumor cavity. Cover the cortical bone piece that was removed when the window was opened. Close the wound. The tumor tissue is composed of neoplastic lobulated cartilage, the cells are rich, no obvious polymorphism, and the nuclear size is not consistent, and binuclear cells (HE×40) are seen. At 11 months after surgery, X-ray films showed bone graft healing without signs of multiple complications. The finger flexion and extension function is good.