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[目的]观察应用三切口(前内、前外、后外)任意组合联合入路的手术方式治疗踝关节弥漫性腱鞘滑膜巨细胞瘤的疗效。[方法]自2010年10月~2014年5月对15例踝关节弥漫性巨细胞瘤的患者采用三切口任意组合联合入路的手术入路方式进行肿块的完整切除术,并对损伤的韧带进行修复和对不稳定的关节进行固定,采用美国骨科足踝外科协会(AOFAS)踝关节功能评分系统进行评分。[结果]15患者获得12~40个月(平均28.3个月)的随访,患者均未复发,术后8个月踝关节功能AOFAS评分65~93分,平均分83.6分,其中优7例,良5例,一般3例,优良率80.2%。[结论]根据肿块具体位置来选择三切口任意组合联合入路的手术入路方式对踝关节弥漫性腱鞘滑膜巨细胞瘤进行彻底的病灶切除,可以有效地降低复发率,术中并对损伤的韧带和关节进行修复,以保证术后踝关节功能恢复良好。
[Objective] To observe the curative effect of diffuse ganglion synovial giant cell tumor of the ankle joint by using three combined incision (anterior, anterolateral and posterior) combined approach. [Method] From October 2010 to May 2014, 15 patients with diffuse giant cell tumor of the ankle were treated with the combined approach of three incisions and all the way to perform the complete resection of the tumor. The ligaments They were repaired and the unstable joints were fixed. The AOFAS ankle joint function scoring system was used to score the scores. [Results] Fifteen patients were followed up for 12 to 40 months (mean, 28.3 months). All patients had no recurrence. After 8 months, the AOFAS scores of ankle joint function ranged from 65 to 93 with a mean score of 83.6, of which 7 were excellent, Good in 5 cases, generally 3 cases, excellent and good rate of 80.2%. [Conclusion] According to the specific location of the tumor, the triple incision combined with any combination of the three approaches can be used to complete the resection of diffuse tendon sheath synovial giant cell tumor of the ankle, which can effectively reduce the recurrence rate. Intraoperative and injury Of the ligaments and joints to repair, to ensure postoperative ankle function recovered well.