J Korean Orthop Assoc.  2012 Jun;47(3):178-184. 10.4055/jkoa.2012.47.3.178.

Outcomes from Treatment of Simple Bone Cyst in the Long Bones with Flexible Intramedullary Nailing in Children and Adolescents: A Retrospective Cases Series

• Cha SM
• Shin HD
• Kim KC
• Hwang JM
• Kim BK

• KMID: 2106645
• DOI: http://doi.org/10.4055/jkoa.2012.47.3.178

Abstract

PURPOSE
A retrospective review of cases series about the outcomes of treatment for simple bone cyst in the long bones with flexible intramedullary nailing in children and adolescents.
MATERIALS AND METHODS
Eighty-five cases with a simple bone cyst in the long bones diagnosed between April 2002 and December 2007 were enrolled in the study. The mean age of the patients was 10.8 years. Thirteen cases were accompanied by a pathological fracture, and 72 cases were not. Thirty-three cases had a simple bone cyst on the proximal humerus, 41 cases on the shaft of the humerus, and 11 cases on the proximal femur. Steroid injections were performed in 21 cases (group 1), curettage and a synthetic bone graft in 18 cases (group 2), and decompression and fixation using flexible intramedullary nailing in 46 cases (group 3). We followed up all cases for at least 24 months and evaluated the results according to the Capanna classification.
RESULTS
The mean duration for absorption and healing of bone cysts was 18.4 months in group 1, 10.6 months in group 2, and 5.8 months in group 3. The complete cure rate according to the Capanna classification was 67% in group 1, 56% in group 2, and 78% in group 3. There was one case of recurrence in group 1 (5%), one case in group 2 (6%), and one case in group 3 (2%), as well as two cases of "no response to treatment" in group 1 (9%) and one case in group 2 (6%).
CONCLUSION
Flexible intramedullary nailing for simple bone cysts in children and adolescents is effective for healing cystic lesions with a short healing duration and for mechanical stability.

Keyword

bone cyst; flexible intramedullary nail

MeSH Terms

Absorption
Adolescent
Bone Cysts
Child
Curettage
Decompression
Femur
Fracture Fixation, Intramedullary
Fractures, Spontaneous
Humans
Humerus
Recurrence
Retrospective Studies
Transplants

Figure

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  Figure 1 (A) Pre-operative simple radiograph of a 12-year-old boy, who had simple bone cyst involving the metaphysis of proximal humerus, associated with pathologic fracture. (B, C) Post-operative radiographs show the inserted flexible intramedullary nails. (D) Cyst absorption and bone healing was achieved at post-operative 5 months.

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