• Dr Claude Laurian

Intra Osseous Arteriovenous Malformations of Hand and Foot

Dernière mise à jour : 17 sept. 2020

Treatment Outcome after Open Surgical Cementoplasty in 9 Patients.

Background: To evaluate the benefit of open surgical cementoplasty on the intra osseous nidus in the treatment of arteriovenous malformations (AVMs) on hand and forefoot. Methods: Over the period 2014-2017, 9 consecutive patients underwent open cementoplasty of bone for AVMs of hand and foot. Investigations included digital radiography, Doppler ultrasound, and CT scan with bone and vascular reconstructions. The main outcome end points of this study were: pain, residual AVMs identified by CT scan, and quality of life.

Results: Over a period of 4 years, 65 patients with AVM on hand (38 pts.) or foot (27 pts.) were observed in our institution, 10 pts. (15%) of the cohort had bone involvement. Nine patients (4 F, 5 M) with a mean age of 30 years (range 10-50) were included in this study. On their hand (n=5), skeletal changes were at first metacarpal (2pts), in the proximal and middle phalanx (3 pts.). On their foot (n=4), changes were in the metatarsal (3 pts.), in proximal and distal phalanx (3 pts.). Nine patients had a targeted cementoplasty of the involved bone. On control CT scan, 9 patients had no residual intraosseous AV shunts, 4 had minor shunt around bone. Mean follow-up was 29 months (range 10-55 m). No morbidity, no delays of healing were observed. Disappearance of pain was the dominant impact in all the patients.

Conclusion: Open surgical cementoplasty is a new option for AVMs bone lesions located in the digits and forefoot. The conclusions are restricted by the short period of follow-up.

Keywords: Arteriovenous Malformations; Intraosseous; Cementoplasty; Surgery

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