l******u
发帖数: 586 | 1 背景：
11岁的孩子，目前体育活动只有游泳。
以前小时候（四年前）练过体操，大概半年吧，怕受伤，不让她练了。
前两年练过跳舞，曾经崴脚，很长时间才好。
病情：
三个月前，抱怨右脚脚踝疼，以为崴脚了，过了一个月去看大夫。照MRI，诊断是
Osteochondral Lesion。上cast一个月，又续用boot两周。不疼了。上周恢复游泳训练
，昨天在游泳训练中，又开始疼痛。
大夫的建议是做手术，在骨头上面打洞，刺激骨头自我修复。
我的担心是：
1）手术中损坏growth plate的可能性大不大？
2）手术的预后怎么样？是否彻底解决问题？
还有，一直搞不懂这个到底怎么引起的。难道同以前崴脚有关吗？还是食品营养？孩子
的身体很健康，比同龄人高些，平时很爱活动，从来不疲劳。
恳请这里骨科的朋友指点！多谢！ |
A*******s
发帖数: 9638 | 2 不是骨科，不明白医生的诊断究竟是什么？估计是stress fracture
我感觉炎症而已，会避免一切可能引起复发的运动，如果LZ想避免手术。
★ 发自iPhone App: ChineseWeb 8.6
【在 l******u 的大作中提到】
: 背景：
: 11岁的孩子，目前体育活动只有游泳。
: 以前小时候（四年前）练过体操，大概半年吧，怕受伤，不让她练了。
: 前两年练过跳舞，曾经崴脚，很长时间才好。
: 病情：
: 三个月前，抱怨右脚脚踝疼，以为崴脚了，过了一个月去看大夫。照MRI，诊断是
: Osteochondral Lesion。上cast一个月，又续用boot两周。不疼了。上周恢复游泳训练
: ，昨天在游泳训练中，又开始疼痛。
: 大夫的建议是做手术，在骨头上面打洞，刺激骨头自我修复。
: 我的担心是：
|
l******u
发帖数: 586 | 3 谢谢回复！
从MRI看，确定是骨头有损伤。已经六周保守疗法，但是似乎不奏效（四周上weight
bearing cast，和两周boot)。
希望有更多的朋友提供信息。多谢了！
【在 A*******s 的大作中提到】
: 不是骨科，不明白医生的诊断究竟是什么？估计是stress fracture
: 我感觉炎症而已，会避免一切可能引起复发的运动，如果LZ想避免手术。
:
: ★ 发自iPhone App: ChineseWeb 8.6
|
M**W
发帖数: 2 | 4 From what you have described, your child is likely have OLT (Osteochondral
Lesions of
the Talus. Other terms used before are osteochondral defects (OCD),
osteochondritis dissecans, and transchondral fracture, etc.
Most of the time, it is considered a result of acute or repetitive
microtrauma.The severity of the injury depend on the size, depth,amount of
displacement and separation. Nothing to do with your kid's nutrition.
Your surgeon suggested is arthroscopic debridement and microfracture.
Currently, the best available operative treatment in adults is arthroscopic
debridement and bone marrow stimulation (usually through microfracture),
which has a success rate of 85 %. OLT in children is rare, limited reports
has good outcomes of surgical management if refractory and failed
conservative measures. There are other options depending on the size and
morphology of the lesion (ORIF, graft, etc.) The growth plate concern mostly
related to the need of osteotomy from tibia if the lesion is hard to access
. However, it is not needed most of the time in adults.Very limited reports
in children anyway.
The best options would be find a real good orthopedic foot & ankle
specialist or pediatric orthopedist with sports medicine training and look
for their advices and second opinions. Let me know where you are if you do
not mind or send me message so that I can give you a few names to look for.
Best of the lucks and hope your child feel better soon. |
l******u
发帖数: 586 | 5 太感谢您的答复了！我们考虑的手术是BMS。
现在的大夫在达拉斯的Southlake，我们计划要2nd opinion。请推荐附近有名望的骨科
运动大夫！
多谢了！
arthroscopic
【在 M**W 的大作中提到】
: From what you have described, your child is likely have OLT (Osteochondral
: Lesions of
: the Talus. Other terms used before are osteochondral defects (OCD),
: osteochondritis dissecans, and transchondral fracture, etc.
: Most of the time, it is considered a result of acute or repetitive
: microtrauma.The severity of the injury depend on the size, depth,amount of
: displacement and separation. Nothing to do with your kid's nutrition.
: Your surgeon suggested is arthroscopic debridement and microfracture.
: Currently, the best available operative treatment in adults is arthroscopic
: debridement and bone marrow stimulation (usually through microfracture),
|
M**W
发帖数: 2 | 6 You are welcome.
I replied to your message in your mailbox. |
l******u
发帖数: 586 | |
l******u
发帖数: 586 | 8 背景：
11岁的孩子，目前体育活动只有游泳。
以前小时候（四年前）练过体操，大概半年吧，怕受伤，不让她练了。
前两年练过跳舞，曾经崴脚，很长时间才好。
病情：
三个月前，抱怨右脚脚踝疼，以为崴脚了，过了一个月去看大夫。照MRI，诊断是
Osteochondral Lesion。上cast一个月，又续用boot两周。不疼了。上周恢复游泳训练
，昨天在游泳训练中，又开始疼痛。
大夫的建议是做手术，在骨头上面打洞，刺激骨头自我修复。
我的担心是：
1）手术中损坏growth plate的可能性大不大？
2）手术的预后怎么样？是否彻底解决问题？
还有，一直搞不懂这个到底怎么引起的。难道同以前崴脚有关吗？还是食品营养？孩子
的身体很健康，比同龄人高些，平时很爱活动，从来不疲劳。
恳请这里骨科的朋友指点！多谢！ |
A*******s
发帖数: 9638 | 9 不是骨科，不明白医生的诊断究竟是什么？估计是stress fracture
我感觉炎症而已，会避免一切可能引起复发的运动，如果LZ想避免手术。
★ 发自iPhone App: ChineseWeb 8.6
【在 l******u 的大作中提到】
: 背景：
: 11岁的孩子，目前体育活动只有游泳。
: 以前小时候（四年前）练过体操，大概半年吧，怕受伤，不让她练了。
: 前两年练过跳舞，曾经崴脚，很长时间才好。
: 病情：
: 三个月前，抱怨右脚脚踝疼，以为崴脚了，过了一个月去看大夫。照MRI，诊断是
: Osteochondral Lesion。上cast一个月，又续用boot两周。不疼了。上周恢复游泳训练
: ，昨天在游泳训练中，又开始疼痛。
: 大夫的建议是做手术，在骨头上面打洞，刺激骨头自我修复。
: 我的担心是：
|
l******u
发帖数: 586 | 10 谢谢回复！
从MRI看，确定是骨头有损伤。已经六周保守疗法，但是似乎不奏效（四周上weight
bearing cast，和两周boot)。
希望有更多的朋友提供信息。多谢了！
【在 A*******s 的大作中提到】
: 不是骨科，不明白医生的诊断究竟是什么？估计是stress fracture
: 我感觉炎症而已，会避免一切可能引起复发的运动，如果LZ想避免手术。
:
: ★ 发自iPhone App: ChineseWeb 8.6
|
|
|
M**W
发帖数: 2 | 11 From what you have described, your child is likely have OLT (Osteochondral
Lesions of
the Talus. Other terms used before are osteochondral defects (OCD),
osteochondritis dissecans, and transchondral fracture, etc.
Most of the time, it is considered a result of acute or repetitive
microtrauma.The severity of the injury depend on the size, depth,amount of
displacement and separation. Nothing to do with your kid's nutrition.
Your surgeon suggested is arthroscopic debridement and microfracture.
Currently, the best available operative treatment in adults is arthroscopic
debridement and bone marrow stimulation (usually through microfracture),
which has a success rate of 85 %. OLT in children is rare, limited reports
has good outcomes of surgical management if refractory and failed
conservative measures. There are other options depending on the size and
morphology of the lesion (ORIF, graft, etc.) The growth plate concern mostly
related to the need of osteotomy from tibia if the lesion is hard to access
. However, it is not needed most of the time in adults.Very limited reports
in children anyway.
The best options would be find a real good orthopedic foot & ankle
specialist or pediatric orthopedist with sports medicine training and look
for their advices and second opinions. Let me know where you are if you do
not mind or send me message so that I can give you a few names to look for.
Best of the lucks and hope your child feel better soon. |
l******u
发帖数: 586 | 12 太感谢您的答复了！我们考虑的手术是BMS。
现在的大夫在达拉斯的Southlake，我们计划要2nd opinion。请推荐附近有名望的骨科
运动大夫！
多谢了！
arthroscopic
【在 M**W 的大作中提到】
: From what you have described, your child is likely have OLT (Osteochondral
: Lesions of
: the Talus. Other terms used before are osteochondral defects (OCD),
: osteochondritis dissecans, and transchondral fracture, etc.
: Most of the time, it is considered a result of acute or repetitive
: microtrauma.The severity of the injury depend on the size, depth,amount of
: displacement and separation. Nothing to do with your kid's nutrition.
: Your surgeon suggested is arthroscopic debridement and microfracture.
: Currently, the best available operative treatment in adults is arthroscopic
: debridement and bone marrow stimulation (usually through microfracture),
|
M**W
发帖数: 2 | 13 You are welcome.
I replied to your message in your mailbox. |
l******u
发帖数: 586 | |
s*****n
发帖数: 994 | |
