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내과의 부분후방절골술을 통한 거골연골모세포종의 수술적 치료: 증례 보고

Surgical Treatment of Talar Chondroblastoma via Partial Posterior Medial Malleolar Osteotomy: A Case Report

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초록

During bone tumor resection, many cases require medial malleolar osteotomy to achieve adequate access to the operative field. Various osteotomy methods have been developed to address this issue, including oblique, transverse, reverse V-shape, and step-cut osteotomies. However, medial malleolar osteotomy has several drawbacks, such as the excessive disruption of the joint surface, unstable screw fixa- tion when fixing the medial malleolus, and iatrogenic medial ankle joint arthritis due to articular displacement during the reduction of the osteotomy site. In addition, there is a possibility of injury to the posterior tibial artery, tibial nerve, or posterior tibialis tendon if the osteotomy range is too aggressive. Therefore, the authors propose a new osteotomy method, which has shown promising clinical results, namely, partial posterior medial malleolar osteotomy. This method minimizes articular involvement and provides adequate access to the operative field during talar body bone tumor resection.

Abstract

During bone tumor resection, many cases require medial malleolar osteotomy to achieve adequate access to the operative field. Various osteotomy methods have been developed to address this issue, including oblique, transverse, reverse V-shape, and step-cut osteotomies. However, medial malleolar osteotomy has several drawbacks, such as the excessive disruption of the joint surface, unstable screw fixa- tion when fixing the medial malleolus, and iatrogenic medial ankle joint arthritis due to articular displacement during the reduction of the osteotomy site. In addition, there is a possibility of injury to the posterior tibial artery, tibial nerve, or posterior tibialis tendon if the osteotomy range is too aggressive. Therefore, the authors propose a new osteotomy method, which has shown promising clinical results, namely, partial posterior medial malleolar osteotomy. This method minimizes articular involvement and provides adequate access to the operative field during talar body bone tumor resection.

참고문헌 (10)

  1. Ravish V. Ningegowda, "Chondroblastoma of the Talus", The Journal of Foot and Ankle Surgery, 52(5), pp.673~677 (2013), Elsevier BV[DOI]
  2. 최준영, "동맥류성 골낭종으로 오인된 거골에 발생한 연골모세포종: 증례 보고", 대한족부족관절학회지, 23(1), pp.31~34 (2019), 대한족부족관절학회[DOI]
  3. Yong Hu, "A Novel Medial Malleolar Osteotomy Technique for the Treatment of Osteochondral Lesions of the Talus", Orthopaedic Journal of Sports Medicine, 9(3), pp.232596712198998~ (2021), SAGE Publications[DOI]
  4. Robert W. Mendicino, "Oblique medial malleolar osteotomy for the management of talar dome lesions", The Journal of Foot and Ankle Surgery, 37(6), pp.516~523 (1998), Elsevier BV[DOI]
  5. Rajiv Shah, "An Improved Technique for Medial Malleolar Osteotomy", Tech Foot Ankle Surg, 20(3), pp.171~174 (2021), Ovid Technologies (Wolters Kluwer Health)[DOI]
  6. Yan Zhang, "Triplane osteotomy combined with talar non-weight-bearing area autologous osteochondral transplantation for osteochondral lesions of the talus", BMC Musculoskeletal Disorders, 23(1), pp.79~ (2022), Springer Science and Business Media LLC[DOI]
  7. Khodamorad Jamshidi, "Intraosseous Ganglion Cyst of the Talus Treated With Curettage and Bone Grafting Through a Medial Malleolus Osteotomy", Foot & Ankle International, 44(2), pp.118~124 (2022), SAGE Publications[DOI]
  8. Sujit Tripathy, "Medial malleolar osteotomy for intralesional curettage and bone grafting of primary aneurysmal bone cyst of the talus", BMJ Case Reports, 14(5), pp.e242452~ (2021), BMJ[DOI]
  9. Erik A. Magnusson, "Does a Medial Malleolar Osteotomy or Posteromedial Approach Provide Greater Surgical Visualization for the Treatment of Talar Body Fractures?", Journal of Bone and Joint Surgery, 103(24), pp.2324~2330 (2021), Ovid Technologies (Wolters Kluwer Health)[DOI]
  10. Christiaan J. A. van Bergen, "Direction of the oblique medial malleolar osteotomy for exposure of the talus", Archives of Orthopaedic and Trauma Surgery, 131(7), pp.893~901 (2010), Springer Science and Business Media LLC[DOI]

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