Joint preservation reconstruction for treatment of recurrent juxtaphyseal upper tibial aneurysmal bone cyst using Ilizarov external fixator

Abstract

Background Aneurysmal bone cyst is a rare destructive nonneoplastic lesion that has the distended appearance of an aneurysm. In this study we describe the treatment of recurrent juxtaphyseal upper tibial aneurysmal bone cyst using the Ilizarov technique. Methods We present five children with recurrent aneurysmal bone cyst of the upper tibial metaphysis who were treated by acute shortening and lengthening of the distal tibia using Ilizarov distraction osteogenesis. The mean age of patients was 12 years (range 10–15 years). The mean length of the lesions was 5.4 cm (range 5–6 cm) and the mean width was 5.25 cm (range 5–5.5 cm). All had an open growth plate. Three children had two recurrences and two had single recurrence. All previously were treated by curettage and autogenous bone graft. Results The mean length of follow-up was 2.4 years (range 2–3 years). The mean distraction index was 10.4 days/cm and the mean external fixation index was 21.2 days/cm. There was healing of the cyst in all patients with no recurrence. The level of function was maintained to the preoperative level. Conclusions The use of an Ilizarov device in acute shortening and distraction osteogenesis for lengthening in patients with recurrent aneurysmal bone cyst is safe with few complications. It is an effective joint preserving method of treatment.