期刊论文详细信息
BMC Musculoskeletal Disorders
Predictive characteristic of simple bone cyst treated with curettage and bone grafting
Kryspin Niedzielski1  Zbigniew Lipczyk1  Anna Niewola1  Krzysztof Malecki1  Pawel Flont1 
[1] Clinic of Orthopaedic and Traumatology, Polish Mother’s Memorial Hospital Research Institute, Rzgowska 281/289, Lodz, 93-338, Poland
关键词: Recurrences;    Curettage;    Children;    Simple bone cyst;   
Others  :  1234019
DOI  :  10.1186/s12891-015-0797-6
 received in 2015-07-21, accepted in 2015-10-31,  发布年份 2015
PDF
【 摘 要 】

Background

The efficiency of treating simple bone cyst (SBC) is low. Depending on the choice of treatment, a positive response occurs in 20 to 80 % of cases. These rates are unacceptable, particularly considering they concern the treatment of benign lesions affecting children. Although cyst curettage is one of the first known ways of treating SBC, no precise qualification criteria exists for this procedure. The aim of our study is to identify which type of cyst may be most effectively treated using curettage with grafting.

Methods

A retrospective analysis was performed on 24 patients referred to our clinic for SBC treatment. To identify predictive factors, the group of patients who positively responded to treatment (Neer stages I and II, n = 14) were compared with the group in which recurrences occurred (Neer stages III and IV, n = 10).

Results

Significantly fewer patients with lesions located in the humerus (chi 2  = 9.351; p <0.05) and without pathological facture at the time of diagnosis (p = 0.017) were found in the group with no recurrence. The following radiological parameters were found to vary significantly between groups: cyst area (z = 3.121; p < 0.01), cyst index (z = 2.213; p <0.05) and cyst diameter ratio (z = 2.202; p <0.05). In the group with no recurrences, the mean values of these parameters were found to be lower than in group with poor response to treatment. No statistically significant differences regarding age, sex or type of bone graft (p > 0.05) were found. Recurrences were experienced by 10 patients (41.7 %) during the 3-year period after surgery

Conclusion

In the group treated with curettage, associations were identified between worse treatment results and the location in the humerus, pathological fractures at the time of diagnosis, large cyst area, large cyst index and large cyst diameter.

【 授权许可】

   
2015 Flont et al.

【 预 览 】
附件列表
Files Size Format View
20151125044342716.pdf 3266KB PDF download
Fig. 2. 50KB Image download
Fig. 1. 63KB Image download
【 图 表 】

Fig. 1.

Fig. 2.

【 参考文献 】
  • [1]Zehetgruber H, Bittner B, Gruber D, Krepler P, Trieb K, Kotz R, Dominkus M. Prevalence of aneurysmal and solitary bone cysts in young patients. Clin Orthop Relat Res. 2005; 439:136-43.
  • [2]Cohen J. Simple bone cysts. Studies of cyst fluid in six cases with a theory of pathogenesis. J Bone Joint Surg Am. 1960; 42:609-15.
  • [3]Chigira M, Maehara S, Arita S, Udagawa E. The aetiology and treatment of simple bone cysts. J Bone Joint Surg Br. 1983; 65:633-37.
  • [4]Watanabe H, Arita S, Chigira M. Aetiology of a simple bone cyst. Case Report. 1994; 18:16-9.
  • [5]Shindell R, Huurman WW, Lippiello L, Connolly JF. Prostaglandin levels in unicameral bone cysts treated by intralesional steroid injection. J Pediatr Orthop. 1989; 9:516-19.
  • [6]Komiya S, Minamitani K, Sasaguri Y, Hashimoto S, Morimatsu M, Inoue A. Simple bone cyst. Treatment by trepanation and studies on bone resorptive factors in cyst fluid with a theory of its pathogenesis. Clin Orthop Relat Res. 1993; 287:204-11.
  • [7]Komiya S, Kawabata R, Zenmyo M, Hashimoto S, Inoue A. Increased concentrations of nitrate and nitrite in the cyst fluid suggesting increased nitric oxide synthesis in solitary bone cysts. J Orthop Res. 2000; 18:281-88.
  • [8]Richkind KE, Mortimer E, Mowery-Rushton P, Fraire A. Translocation (16;20)(p11.2;q13). sole cytogenetic abnormality in a unicameral bone cyst. Cancer Genet Cytogenet. 2002; 137:153-55.
  • [9]Vayego SA, De Conti OJ, Varella-Garcia M. Complex cytogenetic rearrangement in a case of unicameral bone cyst. Cancer Genet Cytogenet. 1996; 86:46-9.
  • [10]Scaglietti O, Marchetti PG, Bartolozzi P. Final results obtained in the treatment of bone cysts with methylprednisolone acetate (depo-medrol) and a discussion of results achieved in other bone lesions. Clin Orthop Relat Res. 1982; 165:33-42.
  • [11]Shinozaki T, Arita S, Watanabe H, Chigira M. Simple bone cysts treated by multiple drill-holes. 23 cysts followed 2–10 years. Acta Orthop Scand. 1996; 67:288-90.
  • [12]Abdel-Wanis ME, Tsuchiya H, Uehara K, Tomita K. Minimal curettage, multiple drilling, and continuous decompression through a cannulated screw for treatment of calcaneal simple bone cysts in children. J Pediatr Orthop. 2002; 22:540-43.
  • [13]Lokiec F, Ezra E, Khermosh O, Wientroub S. Simple bone cysts treated by percutaneous autologous marrow grafting. A preliminary report. J Bone Joint Surg Br. 1996; 78:934-37.
  • [14]Killian JT, Wilkinson L, White S, Brassard M. Treatment of unicameral bone cyst with demineralized bone matrix. J Pediatr Orthop. 1998; 18:621-24.
  • [15]Altermatt S, Schwöbel M, Pochon JP. Operative treatment of solitary bone cysts with tricalcium phosphate ceramic. A 1 to 7 year follow-up. Eur J Pediatr Surg. 1992; 2:180-82.
  • [16]Neer CS, Francis KC, Marcove RC, Terz J, Carbonara PN. Treatment of unicameral bone cyst. A follow-up study of one hundred seventy-five cases. J Bone Joint Am. 1966; 48:731-45.
  • [17]Campanacci M, Capanna R, Picci P. Unicameral and aneurysmal bone cysts. Clin Orthop Relat Res. 1986; 204:25-36.
  • [18]Bovill DF, Skinner HB. Unicameral bone cysts. A comparison of treatment options. Orthop Rev. 1989; 18:420-27.
  • [19]Mylle J, Burssens A, Fabry G. Simple bone cysts. A review of 59 cases with special reference to their treatment. Arch Orthop Trauma Surg. 1992; 111:297-300.
  • [20]Enneking WF. A system of staging musculoskeletal. Clin Orthop Relat Res. 1986; 204:9-24.
  • [21]Kaelin AJ, MacEwen GD. Unicameral bone cysts. Natural history and the risk of fracture. Int Orthop. 1989; 13:275-82.
  • [22]Kanellopoulos AD, Mavrogenis AF, Papagelopoulos PJ, Soucacos PN. Elastic intramedullary nailing and DBM-bone marrow injection for the treatment of simple bone cysts. World J Surg Oncol. 2007; 5:111. BioMed Central Full Text
  • [23]Chang CH, Stanton RP, Glutting J. Unicameral bone cysts treated by injection of bone marrow or methylprednisolone. J Bone Joint Surg Br. 2002; 84:407-12.
  • [24]Schreuder HW, Conrad EU, Bruckner JD, Howlett AT, Sorensen LS. Treatment of simple bone cysts in children with curettage and cryosurgery. J Pediatr Orthop. 1997; 17:814-20.
  • [25]Peltier LF, Jones RH. Treatment of unicameral bone cysts by curettage and packing with plaster-of-Paris pellets. J Bone Joint Surg Am. 1978; 60:820-22.
  • [26]Oppenheim WL, Galleno H. Operative treatment versus steroid injection in the management of unicameral bone cysts. J Pediatr Orthop. 1984; 4:1-7.
  • [27]Mik G, Arkader A, Manteghi A, Dormans JP. Results of a minimally invasive technique for treatment of unicameral bone cysts. Clin Orthop Relat Res. 2009; 467:2949-54.
  文献评价指标  
  下载次数:26次 浏览次数:19次