Abstract

Aneurysmal bone cyst (ABC) is an uncommon pathological condition, which leads to weakening and fracture of the affected part of the bone. Radiologically, ABC is an eccentric, metaphyseal, expansile, lytic and non-neoplastic lesion of the bone, giving blown-out/ballooned/soap-bubble appearance. Though benign, malignant transformation is reported. It accounts for 1–6% of all primary bone tumours with incidence rate of 0.14% annually. Usually occurs during second decade of life and most common sites for the lesions are the tibia, femur, vertebra, pelvis, humerus and fibula. The various treatment modalities include selective arterial embolisation, en-bloc/wide marginal resection and curettage with phenol, liquid nitrogen, etc., use of sclerosing agents and use of autogenic/allogenic bone graft or polymethylmethacrylate, with or without osteosynthesis. There exists controversy regarding optimum treatment of ABC as recurrence rate ranges from 5–40% depending upon the treatment method used. Use of non-vascularised fibular strut graft yields good results as per many studies especially in large lesions. Hereby, we present four cases of ABC, treated by extended curettage or En bloc excision of lesions and reconstruction using fibular strut graft.

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