Abstract
BackgroundSimple or unicameral bone cysts are common benign fluid-filled lesions usually located at the long bones of children before skeletal maturity.MethodsWe 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).ResultsTwo 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.ConclusionElastic 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.
Highlights
Simple or unicameral bone cysts are common benign fluid-filled lesions usually located at the long bones of children before skeletal maturity
The purpose of this study is to describe the technique and present the results of demineralized bone matrix and autologous bone marrow injection in addition to intramedullary cannulation and stabilization for the treatment of large and active simple bone cysts
Combined mechanical and biological treatment of large and active simple bone cysts in long bones using demineralized bone matrix and bone marrow injection, and elastic intramedullary nailing for cyst cannulation, http://www.wjso.com/content/5/1/111 decompression and stabilization is effective
Summary
Simple or unicameral bone cysts are common benign fluid-filled lesions usually located at the long bones of children before skeletal maturity. They form 3% of all bone lesions in this age group. The etiology and pathogenesis of simple bone cysts is uncertain. Various treatment options have been reported for simple bone cysts including crushing of the cyst wall and onlay grafting [6], total resection with bone grafting [7,8], sub-
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