INTRAOSSEOUS LESION OF PHALANX: TWO SIMILAR CASES BUT NOT THE SAME

@#Intraosseous lesions at phalanges are rare. They frequently present with pain and swelling. Fortunately, the majority of the lesions are benign. However, some lesions are destructive and early interventions are required. We report two cases of similar presentations of swelling and discomfort at the little finger for six months. The lytic lesions involved the whole middle phalanx with cortical breach sparing the joints. A provisional diagnosis of osteomyelitis was made, although unlikely. Bone biopsy was performed early to plan for definitive treatment and surgery. Patient 1 was diagnosed for intraosseous gout whereas Patient 2 for epithelioid hemangioma. Both were benign destructive bone lesions. Thus, we counselled the patients for curettage of lesion, bone grafting and spanning external fixation in view of extensive lesion. Patient 1 defaulted treatment. Patient 2 had an uneventful surgery. She regained her grip strength. In two years follow up, there was no evidence of infection, recurrence or malignant transformation.

Clinical application of injectable calcium sulfate with vacuum mixing for grafting bone defects / 中国矫形外科杂志

[Objective]To evaluate the operability and clinical efficacy of injectable calcium sulfate for grafting bone defects.[Method]From June 2004 to August 2005,22 cases with benign bone lesions were treated with curettage and grafting with injectable calcium sulfate bone graft substitute(minimally invasive injectable graft X3,MIIG X3).There were 13 male cases and 9 femal cases.Their average age was 34.6(ranged,4~55).All the 22 cases were followed-up from 23 months to 37 months,average 31.6 months.All cases took radiographic examination regularly after the operation to assess the absorption rate of MIIGX3 and the formation rate of new bone.[Result]This injectable calcium sulfate with vacuum mixing was easy to use,providing complete fill and bony strength instantly when grafting bone defects.According to the raeiographs,MIIGX3 was absorbed almost at the same rate as new bone ingrowth in 8 to 24 weeks.[Conclusion]MIIGX3 is convenient to graft bone defects with fewer complications,capable of absorbing almost at the same rate as replacement of new bone.It's one of the best bone graft substitutes for grafting bone defects induced by benign bone lesions.