Elastic intramedullary nailing and DBM-bone marrow injection for the treatment of simple bone cysts.
BACKGROUND
Simple or unicameral bone cysts are common benign fluid-filled lesions usually located at the long bones of children before skeletal maturity.


METHODS
We performed demineralized bone matrix and iliac crest bone marrow injection combined with elastic intramedullary nailing for the treatment of simple bone cysts in long bones of 9 children with a mean age of 12.6 years (range, 4 to 15 years).


RESULTS
Two of the 9 patients presented with a pathological fracture. Three patients had been referred after the failure of previous treatments. Four patients had large lesions with impending pathological fractures that interfered with daily living activities. We employed a ratio to ascertain the severity of the lesion. The extent of the lesion on the longitudinal axis was divided with the normal expected diameter of the long bone at the site of the lesion. The mean follow-up was 77 months (range, 5 to 8 years). All patients were pain free and had full range of motion of the adjacent joints at 6 weeks postoperatively. Review radiographs showed that all 7 cysts had consolidated completely (Neer stage I) and 2 cysts had consolidated partially (Neer stage II). Until the latest examination there was no evidence of fracture or re-fracture.


CONCLUSIONS
Elastic intramedullary nailing has the twofold benefits of continuous cyst decompression, and early immediate stability to the involved bone segment, which permits early mobilization and return to the normal activities of the pre-teen patients.
Kanellopoulos
Anastasios D
AD
First Department of Orthopaedics, Athens University Medical School, Athens Greece. adkanell@yahoo.com
Mavrogenis
Andreas F
AF
Papagelopoulos
Panayiotis J
PJ
Soucacos
Panayotis N
PN
D000293:Adolescent; D000367:Age Factors; D001845:Bone Cysts / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016026:Bone Marrow Transplantation / Q000379:methods*; D001857:Bone Matrix / Q000637:transplantation*; D001858:Bone Nails; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D005260:Female; D005269:Femur; D005594:Fracture Fixation, Intramedullary / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery*; D006801:Humans; D006811:Humerus; D015552:Injections, Intralesional; D008297:Male; D011859:Radiography; D018570:Risk Assessment