目的 总结 2 例手部掌骨旺炽性反应性骨膜炎诊疗经验。方法 2016 年 5 月及 2017 年 1 月各收治 1 例手部肿物伴疼痛患者。其中,1 例 8 岁女性患儿左手大鱼际可触及一质硬肿物,活动度差,压痛阳性,左拇指活动受限;初步诊断为掌骨旺炽性反应性骨膜炎,行手术切除肿物。1 例 31 岁男性患者右手背第 2 掌骨区可触及一质硬肿物,压痛剧烈,右手各指活动尚好;初步诊断为右手肿物,恶性骨肿瘤可疑;手术行第 2 掌骨截骨、完全切除肿块,并取同侧髂骨修复掌骨缺损。结果 术中切取组织病理检查均诊断为掌骨旺炽性反应性骨膜炎(纤维骨性假瘤)。术后切口均 Ⅰ 期愈合。2 例患者术后分别获随访 2 年及 3 年,肿物未见复发,手指功能恢复正常。结论 掌骨旺炽性反应性骨膜炎早期可以采用姑息和非甾体类抗炎药物保守治疗,晚期具有侵袭性或复发时应行病灶切除术。
Citation:
龚洪洋, 黄东旭, 孙希光, 王子龙, 郑昌艳, 赵媛媛, 路来金. 手部掌骨旺炽性反应性骨膜炎二例. Chinese Journal of Reparative and Reconstructive Surgery, 2020, 34(4): 541-542. doi: 10.7507/1002-1892.201910052
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- 1. Soni A, Weil A, Wei S, et al. Florid reactive periostitis ossificans of the humerus: Case report and differential diagnosis of periosteal lesions of long bones. World J Orthop, 2015, 6(7): 559-563.
- 2. 曾文, 吴伟, 刘勇志. 左髋部旺炽性反应性骨膜炎 1 例. 四川医学, 2013, 34(3): 480.
- 3. 王鹏, 薛冰, 钱贵宾, 等. 右腓骨旺炽性反应性骨膜炎 1 例报告. 中国矫形外科杂志, 2015, 23(7): 671-672.
- 4. Mathew SE, Madhuri V, Alexander M, et al. Florid reactive periostitis of the forearm bones in a child. J Bone Joint Surg (Br), 2011, 93(3): 418-420.
- 5. Tomori Y, Ohashi R, Naito Z, et al. Florid reactive periostitis in the fifth phalange of a professional boxer: A case report. Medicine (Baltimore), 2016, 95(51): e5697.
- 6. 陈佳, 宋玲玲, 张艳, 等. 手指旺炽性反应性骨膜炎 1 例. 医学影像学杂志, 2019, 29(2): 344.
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