El ve el bileğinde tendon kılıfının dev hücreli tümörü: 141 hastanın değerlendirilmesi
Küçük Resim Yok
Tarih
2004
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: El ve el bileği yerleşimli tendon kılıfından gelişen dev hücreli tümörler tanı, tedavi ve ameliyat sonrası dönemde oluşan komplikasyonlar açısından retrospektif olarak değerlendirildi. Çalışma planı: Yirmi bir yıllık bir dönem içinde, el veya el bileği yerleşimli tendon kılıfı dev hücreli tümörü nedeniyle 141 hastanın (83 kadın, 58 erkek; ort. yaş 37.5; dağılım 6-77) 146 lezyonuna cerrahi uygulandı. Lezyonların 134'ü elde, 12'si el bileğinde görüldü. Tutulum 77 olguda sağ, 64 olguda sol tarafta idi. Ortalama izlem süresi 3.5 yıl (dağılım 6 ay-11 yıl) idi. Sonuçlar: Hastaların en sık başvuru nedeni ağrısız yumuşak doku kitlesi idi. Olguların çoğunda tümör (%76) voler bölgede yerleşim göstermekteydi. Yerleşim yeri en sık işaret parmağında (%27), üçüncü parmakta (%24) ve proksimal falanks düzeyinde (%57) idi. Tümörlerin %40'ına 30-50 yaşlar arasında rastlandı. Bulguların süresi bir ay ile beş yıl arasında değişmekteydi. En sık ilk altı ay içinde başvuru gözlendi. On sekiz olguda radyolojik olarak kemik tutulumu saptandı; bunların 12'sinde korti-kal kalınlaşma, sekizinde skleroz görüldü. Ameliyat son-rası dönemde dört olguda dijital sinir hasarı, üç olguda yüzeyel enfeksiyon, 12 olguda eklem sertliği gözlendi. Yirmi üç hastada (%16) ortalama 3.7 yıl içinde (dağılım 2 ay-7 yıl) nüks gelişti. Çıkarımlar: Tendon kılıfının dev hücreli tümörlerinde yüksek nüks oranı göz önüne alınarak, geniş bir cerrahi sahada, titiz bir cerrahi uygulanmalı ve büyütücü gözlükten yararlanılmalıdır.
Objectives: Giantcell tumors of the tendon sheath localized in the hand or wrist were retrospectively reviewec with respect to diagnosis, surgical treatment, and postop-erative complications. Methods: During a 21-year period, a total of 141 patients (83 females, 58 males; mean age 37.5 years; range 6 to 11 years) underwent surgery for 146 lesions that developec in the hand (n=134) or the wrist (n=12). Involvement was on the right side in 77 patients, and on the left side in 64 patients. The mean follow-up period was 3.5 years (range 6 months to 11 years). Results: On presentation, the most common symptom was the presence of a painless soft tissue mass. The most frequem localization was the volarpart (76%) of the second (27%) anc the third (24) fingers, or the proximal phalanx (57%). Fort) per cent of tumors were encountered at ages between 30 and 50 years. The duration of symptoms ranged from one month to five years and the highest number of presentations fell within the first six months. In eighteen patients, radiologic studies showed osseous involvement, being cortical sclerosis in 12 patients, and erosion in eight patients. Postoperative complications included digital nerve injuries in four patients. superficial infection in three patients, and joint stiffness in 12 patients. Twenty-three patients (16%) developed recurrences within a mean of 3.7 years (range 2 months to 7 years). Conclusion: Taking high rates of recurrences into consideration, surgery for giant-cell tumors of the tendon sheath requires wide surgical exposure, attentive skills, and the use of magnification.
Objectives: Giantcell tumors of the tendon sheath localized in the hand or wrist were retrospectively reviewec with respect to diagnosis, surgical treatment, and postop-erative complications. Methods: During a 21-year period, a total of 141 patients (83 females, 58 males; mean age 37.5 years; range 6 to 11 years) underwent surgery for 146 lesions that developec in the hand (n=134) or the wrist (n=12). Involvement was on the right side in 77 patients, and on the left side in 64 patients. The mean follow-up period was 3.5 years (range 6 months to 11 years). Results: On presentation, the most common symptom was the presence of a painless soft tissue mass. The most frequem localization was the volarpart (76%) of the second (27%) anc the third (24) fingers, or the proximal phalanx (57%). Fort) per cent of tumors were encountered at ages between 30 and 50 years. The duration of symptoms ranged from one month to five years and the highest number of presentations fell within the first six months. In eighteen patients, radiologic studies showed osseous involvement, being cortical sclerosis in 12 patients, and erosion in eight patients. Postoperative complications included digital nerve injuries in four patients. superficial infection in three patients, and joint stiffness in 12 patients. Twenty-three patients (16%) developed recurrences within a mean of 3.7 years (range 2 months to 7 years). Conclusion: Taking high rates of recurrences into consideration, surgery for giant-cell tumors of the tendon sheath requires wide surgical exposure, attentive skills, and the use of magnification.
Açıklama
Anahtar Kelimeler
Cerrahi
Kaynak
Acta Orthopaedica et Traumatologica Turcica
WoS Q Değeri
Scopus Q Değeri
Cilt
38
Sayı
2
