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Elastic intramedullary nailing and DBM-bone marrow injection for the treatment of simple bone cysts.

Kanellopoulos AD, Mavrogenis AF, Papagelopoulos PJ, Soucacos PN - World J Surg Oncol (2007)

Bottom Line: The mean follow-up was 77 months (range, 5 to 8 years).All patients were pain free and had full range of motion of the adjacent joints at 6 weeks postoperatively.Until the latest examination there was no evidence of fracture or re-fracture.

View Article: PubMed Central - HTML - PubMed

Affiliation: First Department of Orthopaedics, Athens University Medical School, Athens Greece. adkanell@yahoo.com

ABSTRACT

Background: Simple or unicameral bone cysts are common benign fluid-filled lesions usually located at the long bones of children before skeletal maturity.

Methods: We performed demineralized bone matrix and iliac crest bone marrow injection combined with elastic intramedullary nailing for the treatment of simple bone cysts in long bones of 9 children with a mean age of 12.6 years (range, 4 to 15 years).

Results: Two of the 9 patients presented with a pathological fracture. Three patients had been referred after the failure of previous treatments. Four patients had large lesions with impending pathological fractures that interfered with daily living activities. We employed a ratio to ascertain the severity of the lesion. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion. The mean follow-up was 77 months (range, 5 to 8 years). All patients were pain free and had full range of motion of the adjacent joints at 6 weeks postoperatively. Review radiographs showed that all 7 cysts had consolidated completely (Neer stage I) and 2 cysts had consolidated partially (Neer stage II). Until the latest examination there was no evidence of fracture or re-fracture.

Conclusion: Elastic intramedullary nailing has the twofold benefits of continuous cyst decompression, and early immediate stability to the involved bone segment, which permits early mobilization and return to the normal activities of the pre-teen patients.

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We arbitrarily employed a ratio to ascertain the severity of a simple bone cyst. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion. The presented in this study method of treatment has been performed in large unicameral bone cysts that occupied more than 2 times the physiologic diameter of the long bone at the site of the lesion.
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Figure 1: We arbitrarily employed a ratio to ascertain the severity of a simple bone cyst. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion. The presented in this study method of treatment has been performed in large unicameral bone cysts that occupied more than 2 times the physiologic diameter of the long bone at the site of the lesion.

Mentions: The diagnosis was based on typical imaging, cystographic features and histology. Previous studies have used the cyst index [31] and the cyst diameter [32] to measure the state and progress of cystic activity. We employed a radiographic ratio to ascertain the severity of the lesion. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion (Figure 1). The presented herein method of treatment has been performed in large simple bone cysts that occupied more than 2 times the physiologic diameter of the long bone at the site of the lesion.


Elastic intramedullary nailing and DBM-bone marrow injection for the treatment of simple bone cysts.

Kanellopoulos AD, Mavrogenis AF, Papagelopoulos PJ, Soucacos PN - World J Surg Oncol (2007)

We arbitrarily employed a ratio to ascertain the severity of a simple bone cyst. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion. The presented in this study method of treatment has been performed in large unicameral bone cysts that occupied more than 2 times the physiologic diameter of the long bone at the site of the lesion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2117015&req=5

Figure 1: We arbitrarily employed a ratio to ascertain the severity of a simple bone cyst. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion. The presented in this study method of treatment has been performed in large unicameral bone cysts that occupied more than 2 times the physiologic diameter of the long bone at the site of the lesion.
Mentions: The diagnosis was based on typical imaging, cystographic features and histology. Previous studies have used the cyst index [31] and the cyst diameter [32] to measure the state and progress of cystic activity. We employed a radiographic ratio to ascertain the severity of the lesion. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion (Figure 1). The presented herein method of treatment has been performed in large simple bone cysts that occupied more than 2 times the physiologic diameter of the long bone at the site of the lesion.

Bottom Line: The mean follow-up was 77 months (range, 5 to 8 years).All patients were pain free and had full range of motion of the adjacent joints at 6 weeks postoperatively.Until the latest examination there was no evidence of fracture or re-fracture.

View Article: PubMed Central - HTML - PubMed

Affiliation: First Department of Orthopaedics, Athens University Medical School, Athens Greece. adkanell@yahoo.com

ABSTRACT

Background: Simple or unicameral bone cysts are common benign fluid-filled lesions usually located at the long bones of children before skeletal maturity.

Methods: We performed demineralized bone matrix and iliac crest bone marrow injection combined with elastic intramedullary nailing for the treatment of simple bone cysts in long bones of 9 children with a mean age of 12.6 years (range, 4 to 15 years).

Results: Two of the 9 patients presented with a pathological fracture. Three patients had been referred after the failure of previous treatments. Four patients had large lesions with impending pathological fractures that interfered with daily living activities. We employed a ratio to ascertain the severity of the lesion. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion. The mean follow-up was 77 months (range, 5 to 8 years). All patients were pain free and had full range of motion of the adjacent joints at 6 weeks postoperatively. Review radiographs showed that all 7 cysts had consolidated completely (Neer stage I) and 2 cysts had consolidated partially (Neer stage II). Until the latest examination there was no evidence of fracture or re-fracture.

Conclusion: Elastic intramedullary nailing has the twofold benefits of continuous cyst decompression, and early immediate stability to the involved bone segment, which permits early mobilization and return to the normal activities of the pre-teen patients.

Show MeSH
Related in: MedlinePlus