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Solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome
BACKGROUND: Solitary bone cysts (SBC) are benign, tumor-like lesions, which most frequently occur in the proximal metaphyseal-diaphyseal region of the humerus and femur of children and adolescents. The lack of a clear pathoetiology has impeded the development of treatment strategies. Up to date ther...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831090/ https://www.ncbi.nlm.nih.gov/pubmed/27075249 http://dx.doi.org/10.1186/s12891-016-1012-0 |
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author | Traub, Frank Eberhardt, Oliver Fernandez, Fransico F. Wirth, Thomas |
author_facet | Traub, Frank Eberhardt, Oliver Fernandez, Fransico F. Wirth, Thomas |
author_sort | Traub, Frank |
collection | PubMed |
description | BACKGROUND: Solitary bone cysts (SBC) are benign, tumor-like lesions, which most frequently occur in the proximal metaphyseal-diaphyseal region of the humerus and femur of children and adolescents. The lack of a clear pathoetiology has impeded the development of treatment strategies. Up to date there is no consensus or official guideline for when and how treat SBC. The purpose of this study was to evaluate the effectiveness and the longterm clinical outcome of the treatment of SBC. Different techniques have been used dependant of the site of lesion, dimension, medical history and activity status. METHODS: 135 skeletal immature patients with a solitary bone cyst were included. A follow up of 36 months or more was available for all patients. 22 patients were treated conservatively. All the other patients had at least one surgical intervention. The following four surgical treatment modalities were used: injection of methylprednisolon acetat (steroids), intramedullary nailing (IN), IN + steroids and curettage plus bone grafting. RESULTS: There was no significant difference between the treatment groups with respect to secondary fractures, function, pain, or complications. In the individual groups the failure rate after initial treatment was 36,6 % with steroids, 50 % with intramedullary nailing, 21,4 % with intramedullary nailing plus steroids and none in the remaining group. CONCLUSION: Steroid injection remains a reliable method for treating solitary bone cysts owing to its low invasiveness. To prevent fractures and allow a full weight bearing, internal fixation in combination with methylprednisolon acetat injections seems to be the most favorable in weight bearing bones. |
format | Online Article Text |
id | pubmed-4831090 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-48310902016-04-15 Solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome Traub, Frank Eberhardt, Oliver Fernandez, Fransico F. Wirth, Thomas BMC Musculoskelet Disord Research Article BACKGROUND: Solitary bone cysts (SBC) are benign, tumor-like lesions, which most frequently occur in the proximal metaphyseal-diaphyseal region of the humerus and femur of children and adolescents. The lack of a clear pathoetiology has impeded the development of treatment strategies. Up to date there is no consensus or official guideline for when and how treat SBC. The purpose of this study was to evaluate the effectiveness and the longterm clinical outcome of the treatment of SBC. Different techniques have been used dependant of the site of lesion, dimension, medical history and activity status. METHODS: 135 skeletal immature patients with a solitary bone cyst were included. A follow up of 36 months or more was available for all patients. 22 patients were treated conservatively. All the other patients had at least one surgical intervention. The following four surgical treatment modalities were used: injection of methylprednisolon acetat (steroids), intramedullary nailing (IN), IN + steroids and curettage plus bone grafting. RESULTS: There was no significant difference between the treatment groups with respect to secondary fractures, function, pain, or complications. In the individual groups the failure rate after initial treatment was 36,6 % with steroids, 50 % with intramedullary nailing, 21,4 % with intramedullary nailing plus steroids and none in the remaining group. CONCLUSION: Steroid injection remains a reliable method for treating solitary bone cysts owing to its low invasiveness. To prevent fractures and allow a full weight bearing, internal fixation in combination with methylprednisolon acetat injections seems to be the most favorable in weight bearing bones. BioMed Central 2016-04-14 /pmc/articles/PMC4831090/ /pubmed/27075249 http://dx.doi.org/10.1186/s12891-016-1012-0 Text en © Traub et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Traub, Frank Eberhardt, Oliver Fernandez, Fransico F. Wirth, Thomas Solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome |
title | Solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome |
title_full | Solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome |
title_fullStr | Solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome |
title_full_unstemmed | Solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome |
title_short | Solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome |
title_sort | solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4831090/ https://www.ncbi.nlm.nih.gov/pubmed/27075249 http://dx.doi.org/10.1186/s12891-016-1012-0 |
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