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Scheider P, Farr S. Outcomes and complications of surgical treatment modalities for simple bone cysts of the humerus in children and adolescents. Int Orthop 2024; 48:1619-1626. [PMID: 38570348 DOI: 10.1007/s00264-024-06158-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE The aim of this study was to evaluate and compare different surgical treatment modalities for simple bone cysts (SBC) of the humerus regarding their effectiveness and recurrence rate. METHODS In this retrospective study, patients who received surgical treatment for previously untreated primary SBCs of the humerus were analyzed. Demographic data, cyst-specific as well as treatment-specific parameters, complications, treatment failures, and recurrence rates were collected and correlated with different treatment modalities. Observed procedures were categorized as open procedure (n=20) or osteosynthesis alone (n=3). For the open procedure group, four subgroups could be defined. RESULTS Twenty-three patients were included. The mean age at diagnosis was 11.6 ± 2.5 years, and the mean postoperative follow-up was 3.9 ± 2.6 years (range 1.0-10.3). After surgical intervention, a total of five (21.7%) patients showed at least one recurrence. Fracture occurred in three (13.0%) cases. The incidence of treatment failure was significantly higher in the curettage, allograft, adjuvants group, with five (83.3%) of six cases showing recurrence, than in the other subgroups (≤ 25.0%) including the osteosynthesis alone group (p=.024). For the open procedure group, the failure-free survival rates were 80.0% after two years and 50.4% after five years. For the three cases treated by osteosynthesis alone, no failures were observed. CONCLUSION Open procedures showed similar failure rates except for the subgroup using curettage, allograft, and adjuvants which showed significantly higher treatment failure. Promising results were observed in the group which received solely osteosynthesis without cyst excision or filling, as no treatment failure was observed here.
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Affiliation(s)
- Philipp Scheider
- Department of Pediatric Orthopaedics and Foot and Ankle Surgery, Orthopaedic Hospital Speising, Speisingerstraße 109, 1130, Vienna, Austria.
| | - Sebastian Farr
- Department of Pediatric Orthopaedics and Foot and Ankle Surgery, Orthopaedic Hospital Speising, Speisingerstraße 109, 1130, Vienna, Austria
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Liu J, Su Y. Factors which can influence elastic stable intramedullary nailing removal in healed bone cysts in children. Sci Rep 2024; 14:11129. [PMID: 38750240 PMCID: PMC11096159 DOI: 10.1038/s41598-024-61828-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/10/2024] [Indexed: 05/18/2024] Open
Abstract
Elastic stable intramedullary nailing (ESIN) internal fixation is used clinically to treat pathological fractures of bone cysts in children. However, one of the most important complications was removal difficulty. In this study, we aim to analyse the factors which can influence ESIN removal in healed bone cysts in children. From April 2014 to November 2020, the clinical data of 49 children who underwent elastic stable intramedullary nail removal for pathological fractures of the bone cysts in our hospital were retrospectively analysed. The following data, including age, sex, pathological fracture site, with bone graft, number of ESINs, ESIN indwelling time, and extraosseous length of ESIN were collected, and univariate analysis and logistic regression analysis was performed. The frequency of difficulty in ESIN extraction was 44.90% (22/49). The univariate logistic regression analysis showed that age,ESIN indwelling time,with bone garft and extraosseous length of ESIN may be correlated with the difficulty in removing ESIN (P < 0.05), while sex, pathological fracture site, number of ESIN may not be correlated with the difficulty in removing ESIN (P > 0.05).The multivariate logistic regression analysis showed that the ESIN indwelling time was the independent influencing factor for difficulty in removing ESIN (P < 0.05). The factors influencing the ESIN removal in healed bone cysts in children include over 11.79 years old, the long indwelling time of the ESIN(over 10.5 months),with bone graft and short extraosseous length of ESIN(≤ 0.405 cm). These factors influencing ESIN removal in healed bone cysts in children should be considered.
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Affiliation(s)
- Jiao Liu
- Orthopedics Department, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Jiangxi Hospital Affiliated Children's Hospital of Chongqing Medical University, Zhongshan 2Road 136#, Yuzhong District, Chongqing, 400014, People's Republic of China
| | - Yuxi Su
- Orthopedics Department, Children's Hospital of Chongqing Medical University; Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Jiangxi Hospital Affiliated Children's Hospital of Chongqing Medical University, Zhongshan 2Road 136#, Yuzhong District, Chongqing, 400014, People's Republic of China.
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Delarue M, Perez C, Lucidarme Q, Bornert F. Management of a solitary bone cyst using a custom-made surgical guide for a minimally invasive approach: technical note and case report. BMC Oral Health 2024; 24:560. [PMID: 38745168 PMCID: PMC11092003 DOI: 10.1186/s12903-024-04308-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND Solitary Bone Cyst (SBC), also known as a simple bone cyst, hemorrhagic cyst, or traumatic cyst is classified by the WHO among non-odontogenic benign lesions of the jaw. The article explores the use of a static 3D-printed surgical guide to treat mandibular SBC, emphasizing a minimally surgical approach for this lesion. CASE PRESENTATION A 20-year-old woman was referred for a persistent mandibular SBC lacuna, without specific complaints. Her medical history included a previous bone trepanation for a SBC in the same area, radiologically and surgically confirmed. X-ray assessment showed a well-defined unilocular radiolucency surrounding the root of the first left lower molar (tooth #36), measuring 10 × 10 mm. Pulp sensitivity was normal. CBCT data and STL files of dental cast were obtained preoperatively and registered. A 3D-printed surgical guide was used for minimally invasive trepanation of the buccal cortical. The simulation used a targeted endodontic microsurgery approach in order to determine axis and diameter of the trephine. Surgery was performed under local anesthesia. The guide was tooth supported integrating tubes and a fork for guiding precise trepanation. A 3.5 mm round bone window was created, leaving an empty cavity confirming SBC diagnosis and permitting bone curettage. A blood clot was obtained to promote bone healing. Complete reossification was observed after 6 months. The follow-up at 2 years confirmed a complete bone healing with normal pulp sensitivity. DISCUSSION The 3D-printed windowed surgical guide with dental support offers big advantages, including improved visibility and reduced errors. Compared to traditional guides, it eliminates visual hindrance and allows easier and quick access to confined areas as well as an improved irrigation during drilling process. The article also highlights the importance of preoperative planning while acknowledging potential limitations and errors and surgical complications. CONCLUSION The use of the 3D-printed surgical guide could be used in routine for minimally invasive intervention of SBC. This case also demonstrates the potential utility of this approach in various procedures in oral and maxillofacial surgery. The technique provides precise localization, reducing complications and enhances operative efficiency.
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Affiliation(s)
- Maxime Delarue
- Faculty of Dental Surgery, University of Strasbourg, 8 Rue de Sainte Elisabeth, Strasbourg, 67000, France.
- Oral Surgery, UF8601, University Hospital of Strasbourg, 1 Place de l'Hôpital, Strasbourg, 67000, France.
| | - Cyril Perez
- Faculty of Dental Surgery, University of Strasbourg, 8 Rue de Sainte Elisabeth, Strasbourg, 67000, France
- Oral Surgery, UF8601, University Hospital of Strasbourg, 1 Place de l'Hôpital, Strasbourg, 67000, France
| | - Quentin Lucidarme
- Faculty of Dental Surgery, University of Strasbourg, 8 Rue de Sainte Elisabeth, Strasbourg, 67000, France
- Oral Surgery, UF8601, University Hospital of Strasbourg, 1 Place de l'Hôpital, Strasbourg, 67000, France
| | - Fabien Bornert
- Faculty of Dental Surgery, University of Strasbourg, 8 Rue de Sainte Elisabeth, Strasbourg, 67000, France
- Dental Care Unit, UF8611, University Hospital of Strasbourg, Hôpital de Hautepierre, 1 Avenue Molière, Strasbourg, 67098, France
- INSERM (French National Institute of Health and Medical Research), UMR 1260, Regenerative Nanomedicine, CRBS, 1 Rue Eugène Boeckel, Strasbourg, 67000, France
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Rajeswaran S, Wiese M, Baker J, Chesterton J, Samet J, Green J, Riaz A, Mouli S, Thornburg B, Attar S, Peabody T, Donaldson J. Treatment of Unicameral Bone Cysts Utilizing the Sclerograft™ Technique. Cardiovasc Intervent Radiol 2024; 47:346-353. [PMID: 38409561 DOI: 10.1007/s00270-024-03671-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/23/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE To evaluate the Sclerograft™ procedure, which is an image-guided, minimally invasive approach of chemical sclerotherapy followed by bone grafting of unicameral bone cysts (UBC). MATERIALS AND METHODS A retrospective evaluation from August 2018 through August 2023 was performed at a single institution on patients that underwent the Sclerograft™ procedure for UBCs. Radiographic healing was evaluated utilizing the Modified Neer Classification. Two different regenerative grafts, CaSO4-CaPO4 and HA-CaSO4 were utilized. A total of 50 patients were evaluated with 41 patients grafted with CaSO4-CaPO4 and 9 patients grafted with HA-CaSO4. RESULTS The average age of the patient was 12.1 years with an average radiographic follow-up of 14.5 months. Average cyst size was 5.5 cm in the largest dimension and average cyst volume was 20.2 cc. 42 out of 50 (84%) showed healed cysts (Modified Neer Class 1) on the most recent radiograph or MRI. Recurrences occurred on average at 7.2 months. Activity restrictions were lifted at 3-4.5 months post-procedure. Cyst stratification by size did not show a difference in recurrence rates (p = 0.707). There was no significant difference in recurrence rate between lesions abutting the physis compared to those that were not abutting the physis (p = 0.643). There were no major complications. CONCLUSIONS The Sclerograft™ procedure is an image-guided approach to treating unicameral bone cysts, utilizing chemical sclerosis and regenerative bone grafting. The radiographic healing of cysts compares favorably to open curettage and grafting as determined utilizing previously published trials.
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Affiliation(s)
- Shankar Rajeswaran
- Department of Medical Imaging-Interventional Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Avenue, Box 9, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL, 60611, USA
| | - Michelle Wiese
- Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL, 60611, USA.
| | - Joe Baker
- Department of Medical Imaging-Interventional Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Avenue, Box 9, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL, 60611, USA
| | - Julie Chesterton
- Department of Medical Imaging-Interventional Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Avenue, Box 9, Chicago, IL, USA
| | - Jonathan Samet
- Department of Medical Imaging-Interventional Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Avenue, Box 9, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL, 60611, USA
| | - Jared Green
- Joe DiMaggio Children's Hospital, 1005 Joe DiMaggio Dr, Hollywood, FL, 33021, USA
| | - Ahsun Riaz
- Department of Medical Imaging-Interventional Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Avenue, Box 9, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL, 60611, USA
| | - Samdeep Mouli
- Department of Medical Imaging-Interventional Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Avenue, Box 9, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL, 60611, USA
| | - Bartley Thornburg
- Department of Medical Imaging-Interventional Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Avenue, Box 9, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL, 60611, USA
| | - Samer Attar
- Department of Medical Imaging-Interventional Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Avenue, Box 9, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL, 60611, USA
| | - Terrance Peabody
- Department of Medical Imaging-Interventional Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Avenue, Box 9, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL, 60611, USA
| | - James Donaldson
- Department of Medical Imaging-Interventional Radiology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E, Chicago Avenue, Box 9, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, 420 E Superior Street, Chicago, IL, 60611, USA
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Lin CS, Lin SM, Rwei SP, Chen CW, Lan TY. Simple bone cysts of the proximal humerus presented with limb length discrepancy: A case report. World J Clin Cases 2024; 12:1130-1137. [PMID: 38464921 PMCID: PMC10921303 DOI: 10.12998/wjcc.v12.i6.1130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 01/10/2024] [Accepted: 01/30/2024] [Indexed: 02/20/2024] Open
Abstract
BACKGROUND Simple bone cysts (SBC) are benign tumor-like bone lesions typically identified in children. While SBC may lead to growth disturbances or growth arrest, such cases are uncommon. The mechanisms behind these observations remain unclear. Additionally, research on the etiology of SBC remains inconclusive, and there has been no consensus on the appropriate timing and methodology for treatment. CASE SUMMARY Here, we present our experience in the successful surgical management of a 10-year-old girl with SBC, who presented with a pathological fracture complicated by malunion of the displaced fracture, varus deformity, and limb length discrepancy. We hypothesized two possible etiologies for the patient's growth arrest and subsequent humerus varus deformity: (1) Direct disruption of the physis by fluid from the cyst itself; and (2) damage to the epiphysis due to repetitive pathological fractures associated with SBC. In addressing this case, surgical intervention was undertaken to correct the proximal humerus varus deformity. This approach offered the advantages of simultaneously correcting angular abnormalities, achieving mild limb lengthening, providing definitive SBC treatment, and reducing the overall treatment duration. CONCLUSION As per current literature, acute correction of acute angular deformity in proximal humeral SBC is not well comprehended. However, in this specific case, acute correction was considered an optimal solution.
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Affiliation(s)
- Cing Syue Lin
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
| | - Shang Ming Lin
- Department of Materials and Textiles, Asia Eastern University of Science and Technology, New Taipei City 220, Taiwan
| | - Syang-Peng Rwei
- Institute of Organic and Polymeric Materials, National Taipei University of Technology, Taipei City 10608, Taiwan
| | - Chin-Wen Chen
- Institute of Organic and Polymeric Materials, National Taipei University of Technology, Taipei City 10608, Taiwan
| | - Tsung-Yu Lan
- Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
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Nasri E, Reith JD. Aneurysmal bone cyst: a review. J Pathol Transl Med 2023; 57:81-87. [PMID: 36950810 PMCID: PMC10028014 DOI: 10.4132/jptm.2023.02.23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 02/23/2023] [Indexed: 03/24/2023] Open
Abstract
Aneurysmal bone cyst (ABC) is a benign locally destructive bone neoplasm composed of multi-loculated blood-filled cystic spaces. The most common sites of involvement are the meta-diaphysis of the long bones and posterior elements of the vertebrae. Secondary, ABC-like changes can complicate a variety of other benign and malignant primary bone neoplasms, including giant cell tumor, fibrous dysplasia, and osteosarcoma. About two-third of primary ABCs have a rearrangement of the USP6 gene, which is not present in the ABC-like changes that occur secondary to other primary bone tumors (i.e., secondary ABC). Primary ABC of bone carries a variable but generally high rate of local recurrence. This paper provides an overview of the pathophysiology, clinical presentation, radiographic and pathologic findings, treatment, and prognosis of ABC.
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Affiliation(s)
- Elham Nasri
- Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, College of Medicine, Gainesville, FL, USA
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Alkuhaimi TS, Alduraywish I, Alghamdi T, Alawaji A, Aljefri A, Alshaya O, Bauones S. Feasibility of Percutaneous Image-Guided Combined Treatment of Symptomatic Bone Cyst Using Cryoablation and Bone Graft Substitute. Cardiovasc Intervent Radiol 2023. [PMID: 36826492 DOI: 10.1007/s00270-023-03390-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE To describe the feasibility and technique of percutaneous image-guided combined treatment of bone cyst (BC) using cryoablation and bone graft substitute injection. MATERIALS AND METHODS Between July 2019 and January 2022, six consecutive patients (ages between 16 and 33 years) with symptomatic BC in pelvic and lower extremity bones underwent percutaneous image-guided combined treatment using cryoablation and bone graft substitute. To induce bone mineralization as early as possible, the cyst cavity was filled with bone graft substitute. Technical success of the procedure was evaluated, and clinical success was defined as satisfactory clinical symptom relief using visual analogue scale (VAS). Radiologic success was defined as early BC remineralization on radiographic studies. Detailed demographic data with lesion location, size, time to and degree of BC mineralization, complications, clinical outcomes, and radiological follow-up were retrospectively assessed. RESULTS Technical success was 100% achieved in all patients. BC mineralization was observed in all patients, with a median time to reach 80% mineralization at 6 months, with one patient reaching 80% at 5 months and another reaching 100% at 3 months. A significant drop in VAS was observed in all patients, reflecting significant pain relief. There were no major complications. The median follow-up period was 31.5 months, with a minimum follow-up of 5 months and a maximum follow-up of 3 years. CONCLUSION Percutaneous image-guided combined treatment with cryoablation and bone graft substitute for symptomatic BC is technically feasible and was safe in this limited series.
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Strohm JA, Strohm PC, Kühle J, Schmal H, Zwingmann J. Management of juvenile and aneurysmal bone cysts: a systematic literature review with meta-analysis. Eur J Trauma Emerg Surg 2023; 49:361-372. [PMID: 35989377 PMCID: PMC9925490 DOI: 10.1007/s00068-022-02077-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 08/08/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE Numerous approaches to the management of juvenile and aneurysmal bone cysts (ABC) are described in the specialist literature together with discussion of the associated healing and recurrence rates. Since there is currently no evidence-based treatment standard for these conditions, the aim of this systematic literature review with meta-analysis was to examine the different management approaches, evaluate the corresponding clinical outcomes and, as appropriate, to formulate a valid treatment recommendation. METHODS A systematic search on OVID Medline® based on a pre-existing search strategy returned 1333 publications. Having defined inclusion and exclusion criteria and analysis of the relevant full texts, 167 publications were included in the descriptive analysis and 163 in the meta-analysis. For this purpose, different subgroups were created, based on the type of cyst and the therapeutic procedure. Those subgroups were then analysed in relation to their healing rates, the number of recurrences and complication rates. RESULTS For aneurysmal bone cysts, both surgical removal and Doxycycline injection lead to excellent outcomes (98% healing) and low recurrence rates (6% and 11% resp.). Curettage (91% healing), including its combination with autologous cancellous bone graft (96% healing), showed very good healing rates but higher recurrence rates (22% and 15%, resp.), which were however improved by preoperative selective arterial embolization. A critical view must be taken of radiotherapy (90% healing) and the injection of alcohol (92% healing) because of their high complication rates (0.43/cyst and 0.42/cyst, resp.). In the management of juvenile bone cysts, surgical interventions like curettage and cancellous bone graft (87% healing) are far superior to non-surgical approaches (51% healing), furthermore, the application of autologous cancellous bone graft reduced the recurrence rate (3% recurrence) compared to curettage alone (20% recurrence). In subgroup analysis, treatment by ESIN was found to produce excellent outcomes (100% healing), though the patient collectives were small. CONCLUSION Surgical procedures to treat aneurysmal bone cysts appear to be the method of choice whereby Doxycycline injection may be an alternative. A surgical approach should be preferred in the treatment of juvenile bone cysts.
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Affiliation(s)
- Jonas A. Strohm
- grid.5963.9Albert-Ludwigs-University of Freiburg, Freiburg, Germany
| | - Peter C. Strohm
- grid.419802.60000 0001 0617 3250Clinic for Orthopedics and Trauma Surgery, Klinikum Bamberg, Bamberg, Germany
| | - Jan Kühle
- grid.7708.80000 0000 9428 7911Department of Orthopedic and Trauma Surgery, University of Freiburg Medical Center, Freiburg, Germany
| | - Hagen Schmal
- grid.7708.80000 0000 9428 7911Department of Orthopedic and Trauma Surgery, University of Freiburg Medical Center, Freiburg, Germany
| | - Jörn Zwingmann
- Clinic of Orthopedic and Trauma Surgery, Oberschwabenklinik Ravensburg, Ravensburg, Germany
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Ríos-Méndez RE, Espin-Villamarin LG, Rovalino-Troya CJ, Rosero-Lema VF, Barona-Freire EB, Reinoso-Recalde DI. [Andean children with aneurysmal bone cyst treated with polidocanol (use off-label)]. Acta Ortop Mex 2021; 35:529-533. [PMID: 35793253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The aneurysmal bone cyst is a rare benign but aggressive osteolytic tumor for which there is still no ideal treatment, the reports on treatment by sclerotherapy in the pediatric population are scarce and in our region even less. The objective is to communicate the experience of the treatment of aneurysmal bone cyst with polydocanol 3%. MATERIAL Y METHODS Retrospective, descriptive and cross-sectional study. Period: June/2017 to June/2021. Inclusion: patients with histological diagnosis of aneurysmal bone cyst; Under general anesthesia and fluoroscopic guidance, intralesional puncture with 16G needle was performed through which 3% polydocanol was slowly administered. Data: medical history. Quantitative variables shall be expressed in measures of central tendency and dispersion; qualitative variables shall be expressed as frequencies or percentages. RESULTS Nine consecutive patients were included, all of whom had pain and tumor in one of the extremities. Gender: 3 female and 6 male. Age: median 10.5 years (range: 2-15.1). Weight: median 32.8 kg (range: 11-44.5). Total procedures: 44; procedures per patient: mean 4.9 (SD: ± 2.0). Procedure time: mean 33.9 minutes (SD: ± 18.3); radiation: mean 1.34 mGy (SD: ± 1.55). Hospitalization: one day, except one patient. Complications: skin damage in one case, no recurrences follow-up: 12 to 50 months. CONCLUSION In this pediatric series, polydocanol 3% was useful and effective for the treatment of aneurysmal bone cyst, with few complications. One disadvantage is that it requires several sessions and in addition, no significant difference has been demonstrated between other forms of treatment in terms of the recurrence rate.
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Yurac R, Silva A, Delgado M, Nuñez M, Lopez J, Marre B. Pathological axis fracture secondary to a solitary bone plasmacytoma: Two cases and a literature review. Surg Neurol Int 2021; 12:165. [PMID: 33948335 PMCID: PMC8088476 DOI: 10.25259/sni_253_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 03/24/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Solitay bone plasmocytoma (SBP) account for just 5–10% of all plasma cell neoplasms. They are infrequent in the cervical spine, especially involving the C0–C2 segment. In this article we conducted a literature review and present the diagnosis, management and long term course of two patients with SBP of C2 causing cervical instability. Methods: We assessed the clinical records of two patients with SBP in C2 and cervical instability attributed to SP-B involving C2. Both patients presented with progressive, severe cervicalgia, and the “sensation” of skull instability. Magnetic resonance imaging revealed an extensive, infiltrative lesion involving C2 vertebral body and lateral masses, consistent with a plasmacytoma. Results: Both patients underwent emergency posterior surgical stabilization with craniocervical fixation; this was accompanied by a C2 transpedicular biopsy. Postoperatively, patients exhibited no focal neurological deficits and rapidly became pain free. They additional recieved 25 sessions of local conventional radiation therapy. Both patients are doing well as respective 2 and 7-year follow-up. Conclusion: Although rare, unstable SBP may present atypical cervical location that readily responds to surgical descompression/fusion and radiotherapy.
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Affiliation(s)
- Ratko Yurac
- Spine unit, Department of Orthopedic and Traumatology, Clínica Alemana, Santiago, Chile.,Department of Orthopedic and Traumatology, School of Medicine, University del Desarrollo, Santiago, Chile
| | - Alvaro Silva
- Spine unit, Department of Orthopedic and Traumatology, Clínica Alemana, Santiago, Chile.,Department of Orthopedic and Traumatology, School of Medicine, University del Desarrollo, Santiago, Chile
| | - Matias Delgado
- Spine unit, Department of Orthopedic and Traumatology, Clínica Alemana, Santiago, Chile
| | - Marilaura Nuñez
- Department of Orthopedic and Traumatology, School of Medicine, University del Desarrollo, Santiago, Chile
| | - Juan Lopez
- Department of Orthopedic and Traumatology, School of Medicine, University del Desarrollo, Santiago, Chile
| | - Bartolome Marre
- Spine unit, Department of Orthopedic and Traumatology, Clínica Alemana, Santiago, Chile.,Department of Orthopedic and Traumatology, School of Medicine, University del Desarrollo, Santiago, Chile
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Zhang KX, Chai W, Zhao JJ, Deng JH, Peng Z, Chen JY. Comparison of three treatment methods for simple bone cyst in children. BMC Musculoskelet Disord 2021; 22:73. [PMID: 33435945 PMCID: PMC7805037 DOI: 10.1186/s12891-020-03933-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 12/28/2020] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The unicameral bone cyst (UBC) is a kind of benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM), and the combination of ESIN and ABM in the treatment of bone cyst in children. METHODS Eighty-three cases with simple bone cyst were analyzed retrospectively. Twenty-eight cases were treated with ABM. Twenty-eight cases were treated with ESIN. Twenty-seven cases were treated with ABM and ESIN. All cases were diagnosed through X-ray, CT, or MRI scans. For the suspicious ones, the pathological biopsy was performed for an accurate diagnosis. X-ray examinations were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for postoperative evaluation of three methods. RESULTS All cases accomplished the follow-up. The effective rate of the ABM + ESIN group was significantly higher than that of the ABM group (P < 0.05), and the cure rates of the ESIN group and the ABM + ESIN group were higher than that of the ABM group (P < 0.05, respectively). The cure time in the ESIN group was lower than that of the other two groups (P < 0.05, respectively). The times for admission were 2.0 ± 0.0 in the ESIN group, 5.7 ± 1.9 in the ABM group, and 4.7 ± 2.4 in the ABM + ESIN group (P < 0.05 when compared with each other). CONCLUSIONS The method of ABM combined with ESIN for children's bone cyst has the highest effective rate and curative rate. For the individual method, ESIN has a higher effective rate and curative rate than that of ABM. Meanwhile, it has the fewest time of hospitalization.
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Affiliation(s)
- Ke-Xue Zhang
- Medical School of Chinese PLA, Beijing, 100853, China.,Department of Orthopaedics, Chinese PLA General Hospital, Beijing, 100853, China
| | - Wei Chai
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jia-Jia Zhao
- Department of Anesthesiology, Shun Yi District Hospital, Beijing, 101300, China
| | - Jun-Hao Deng
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, 100853, China
| | - Zhan Peng
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, 100853, China
| | - Ji-Ying Chen
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing, 100853, China.
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12
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Marie-Hardy L, El Sayed L, Alves A, Brunelle F, Ouchrif Y, Naggara O, Breton S, Mascard E, Glorion C, Pannier S. Percutaneous alcohol-based sclerotherapy in aneurysmal bone cyst in children and adolescents. Orthop Traumatol Surg Res 2020; 106:1313-1318. [PMID: 32359956 DOI: 10.1016/j.otsr.2019.12.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 11/24/2019] [Accepted: 12/05/2019] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Aneurysmal bone cyst (ABC) is a benign bone lesion of childhood and adolescence. It can be locally aggressive, with risk of fracture. Management is controversial. The aim of the present study was to assess the efficacy, simplicity and tolerance of percutaneous alcohol-bases sclerotherapy in ABC. HYPOTHESIS Alcohol-based sclerotherapy for ABC under radiographic control is safe and effective. MATERIAL AND METHODS A single-center retrospective study for the period 2008-2016 included all of the 55 ABCs, in 54 patients, confirmed on pathology and treated by alcohol-based sclerotherapy under radiographic control. Mean age at diagnosis was 9.6 years. ABC involved the humerus in 30 cases (54%), tibia in 7 (13%) and femur in 5 (9%). Mean follow-up was 50.9 months (range, 16-117 months). Mean number of applications was 1.7 (range, 1-4). Results were assessed clinically (pain, return to sport, limb length and alignment, revision surgery) and radiologically. The main endpoint was lesion volume reduction. The secondary endpoint was failure, defined by open revision surgery or pain preventing return to a sports activity. RESULTS Clinical progression was favorable in 36 patients (67%), and radiological progression in 45 (85%). Only 1 cyst required secondary resection. One patient experienced spontaneously resolving intraoperative bradycardia. Male gender and young age emerged as factors for poorer response. DISCUSSION ABC management in children can be made difficult by lesion size, aggressiveness, location, proximity to the growth plate and small bone stock. Alcohol-based sclerotherapy is simple, reliable and effective in childhood ABC, and may be a first-line attitude, avoiding recourse to invasive surgery. LEVEL OF EVIDENCE IV, retrospective study.
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Affiliation(s)
- Laura Marie-Hardy
- Service de chirurgie orthopédique, hôpital Necker-Enfants-Malades, Paris, France.
| | - Laila El Sayed
- Service de chirurgie orthopédique, hôpital Necker-Enfants-Malades, Paris, France
| | - Alexandra Alves
- Service de chirurgie orthopédique, hôpital Necker-Enfants-Malades, Paris, France
| | - Francis Brunelle
- Service de radiologie, hôpital Necker-Enfants-Malades, Paris, France
| | - Younès Ouchrif
- Service de chirurgie orthopédique, hôpital Necker-Enfants-Malades, Paris, France
| | - Olivier Naggara
- Service d'imagerie morphologique et fonctionnelle, centre hospitalier Sainte-Anne, Paris, France
| | - Sylvain Breton
- Service de radiologie, hôpital Necker-Enfants-Malades, Paris, France
| | - Eric Mascard
- Service de chirurgie orthopédique, hôpital Necker-Enfants-Malades, Paris, France
| | - Christophe Glorion
- Service de chirurgie orthopédique, hôpital Necker-Enfants-Malades, Paris, France
| | - Stéphanie Pannier
- Service de chirurgie orthopédique, hôpital Necker-Enfants-Malades, Paris, France
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13
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Abstract
Background Acetabular roof lesions (ARLs) in children are uncommon and may involve a variety of diseases. The acetabular roof is the main weight-bearing area of the hip joint, and lesions affecting the acetabular roof lead to fluid accumulation in the hip joint, causing hip pain and claudication. Methods for diagnosing and treating ARLs and the prognosis after treatment are rarely reported. We present our experience in a group of children and teenagers with ARLs to retrospectively explore the clinical and imaging features and histopathological diagnosis and report the treatment methods and follow-up observations. Methods Patients with ARLs admitted to the Children’s Hospital of Chongqing Medical University from April 2011 to September 2018 were selected retrospectively. We collected the basic information of patients (name, sex, age), main symptoms and signs, results of various laboratory tests, treatment methods, and intraoperative observations through the hospital medical record system. We collected X-ray, computed tomography (CT), magnetic resonance imaging (MRI) and pathological examination data through the Picture Archiving and Communications System. Follow-up data were collected through an outpatient medical record system, telephone, and chat software (such as WeChat). We used descriptive methods to analyze the lesion structure and destruction mode based on the imaging findings and histopathological diagnosis. Results There were 14 ARL patients, including 6 with eosinophilic granuloma (EG), 5 with chronic osteomyelitis, 2 with bone cyst, and 1 with tuberculosis. One patient underwent percutaneous needle biopsy, 2 underwent open biopsy, and 11 underwent curettage; among them, 5 patients also underwent bone grafting. These lesions had no characteristic imaging findings, and the diagnosis was mainly based on histopathological examination. Most patients showed complete symptom resolution and good hip function at the 1-year follow-up. Conclusion ARLs are not common in children. The types of lesions are diverse and mostly benign, with EG being most common. Malignant tumors may also occur, such as Ewing’s sarcoma, non-Hodgkin’s lymphoma, metastases and neuroblastoma. CT and MRI can be helpful in diagnosing certain cases, but incisional biopsy is required in most cases.
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Affiliation(s)
- Jinkui Wang
- Department of Orthopedics, Children's Hospital of Chongqing Medical University, 2 ZhongShan Rd, ChongQing, 400013, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China.,National Clinical Research Center for Child Health and Disorders (Chongqing), Children's Hospital of Chongqing Medical University, Chongqing, PR China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China.,Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, PR China.,Children's Hospital of Chongqing Medical University, Chongqing, PR China
| | - Zhongliang Wang
- Department of Orthopedics, Children's Hospital of Chongqing Medical University, 2 ZhongShan Rd, ChongQing, 400013, China. .,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China. .,National Clinical Research Center for Child Health and Disorders (Chongqing), Children's Hospital of Chongqing Medical University, Chongqing, PR China. .,China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China. .,Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, PR China. .,Children's Hospital of Chongqing Medical University, Chongqing, PR China.
| | - Jiaqiang Qin
- Department of Orthopedics, Children's Hospital of Chongqing Medical University, 2 ZhongShan Rd, ChongQing, 400013, China.,Ministry of Education Key Laboratory of Child Development and Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China.,National Clinical Research Center for Child Health and Disorders (Chongqing), Children's Hospital of Chongqing Medical University, Chongqing, PR China.,China International Science and Technology Cooperation base of Child development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, PR China.,Chongqing Key Laboratory of Pediatrics, Children's Hospital of Chongqing Medical University, Chongqing, PR China.,Children's Hospital of Chongqing Medical University, Chongqing, PR China
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Manabe H, Sakai T, Morimoto M, Tezuka F, Yamashita K, Takata Y, Sairyo K. Radiological Outcomes of Posterior Lumbar Interbody Fusion Using a Titanium-coated PEEK Cage. J Med Invest 2019; 66:119-122. [PMID: 31064922 DOI: 10.2152/jmi.66.119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Titanium (Ti) coated polyether ether ketone (PEEK) interbody cages (IBCs) have been introduced to overcome any disadvantages. The purpose of this study was to investigate the radiological outcomes of lumbar interbody fusion (LIF) surgery using the Ti-coated PEEK IBC with a minimum of 1-year of follow-up. METHODS A total of 26 intervertebral spaces in consecutive 21 patients who underwent posterior/transforaminal LIF using the Ti-coated PEEK IBC were evaluated. Rates of bone union, screw loosening, cage subsidence and bone cyst formation around the endplate were evaluated on computed tomography scans acquired at least 1 year postoperatively. RESULTS AND DISCUSSION At the 1-year follow-up, bone fusion was achieved in 23 (88.4%) of 26 intervertebral spaces. Cagesubsidence was found in 5 intervertebral spaces ; however,bone fusion was achieved in all these spaces. Bone cysts formed in 4 intervertebral spaces and 4 of 94 screws were found to be loosened. Three of the loosened screws were found in vertebral bodies adjacent to intervertebral spaces with nonunion. However, there was no association between these events. Although more scientific evidence is required to determine the advantages of Ti-coated PEEK IBCs, we believe the clinical outcomes achieved were favorable at the 1 year minimum follow-up. J. Med. Invest. 66 : 119-122, February, 2019.
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Affiliation(s)
- Hiroaki Manabe
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Toshinori Sakai
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Masatoshi Morimoto
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Fumitake Tezuka
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Kazuta Yamashita
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Yoichiro Takata
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Koichi Sairyo
- Department of Orthopedics, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
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15
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Oliveira MBDR, Meohas W, Silva RR, Carvalho GSD, Mello FCDQ, Paschoal MEM. PERCUTANEOUS TREATMENT OF ANEURYSMAL BONE CYST WITH CALCITONIN AND METHYLPREDNISOLONE. Acta Ortop Bras 2018; 26:314-319. [PMID: 30464712 PMCID: PMC6220667 DOI: 10.1590/1413-785220182605201423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To introduce the intralesional calcitonin and methylprednisolone percutaneous injection method, which results in the promotion of primary aneurysmal bone cyst (ABC) healing. METHODS A retrospective cohort study involving 76 patients diagnosed with ABC was performed between 2005 and 2014. Patients treated with calcitonin and methylprednisolone injection and who underwent more than 2 years of follow-up were considered eligible for the study (n=47). The Enneking staging and Capanna classification systems were used during the initial evaluation. Treatment response was assessed by Rastogi radiographic grading based on the degree of healing. X2 and Wilcoxon signed-rank tests and odds ratio calculations were used in the statistical analysis with a 5% significance level. RESULTS The proximal tibia extremity was the most commonly affected site (17.0%). Thirty-three (70.3%) ABC cases were staged as B3 and 28 (59.7%) were classified as type II. The average number of injections performed was 2.8 per patient, with an average reduction of the initial lytic area of 83.7% (p-value=0.00001). Satisfactory results for 91.4% (n=43; p-value=0.00001) were obtained and 5 recurrences occurred. No side effects were observed. CONCLUSION Intralesional calcitonin and methylprednisolone percutaneous injection is a minimally invasive, effective, and safe method for promoting primary ABC healing. Level of evidence IV, Type of study: case series.
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Affiliation(s)
- Marcelo Bragança dos Reis Oliveira
- Instituto Nacional de Traumatología e Ortopedia, Brazil; Universidade Federal do Rio de Janeiro, Brazil; Escola de Saúde do Exército, Brazil
| | - Walter Meohas
- Instituto Nacional de Traumatología e Ortopedia, Brazil
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16
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Ulici A, Florea DC, Carp M, Ladaru A, Tevanov I. Treatment of the aneurysmal bone cyst by percutaneous intracystic sclerotherapy using ethanol ninety five percent in children. Int Orthop 2018; 42:1413-1419. [PMID: 29492610 DOI: 10.1007/s00264-018-3841-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 02/11/2018] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Aneurysmal bone cyst (ABC) is a benign intraosseous lesion filled with blood that can determine a blowout distension of the bone. The purpose of this study is to evaluate the efficacy of sclerotherapy by percutaneous intralesional administration of ethanol 96% for the treatment of this pathology in paediatric patients. METHOD The retrospective study includes 17 paediatric patients with ABC who were treated by repeated intracystic injection with ethanol 96%, 1 ml/kg, in our clinic between December 2015 and July 2017. Fluoroscopic guidance was used to inject the cyst with contrast agent. The mean follow-up period was 11 months. RESULTS AND DISCUSSION All cysts are healed or are in the healing process. The mean age was 11 years old. Seven patients needed three repeated injections and ten patients needed two injections until healing. We observed a mean reduction in the size of the lesions, measured on plain X-rays, of 68%. The complications that were observed included the following: dizziness after injection, skin pigmentation at the injection site, local inflammatory reaction, and pain after injection. The current study approves the importance of this minimally invasive treatment with no recurrence after a follow-up of 19 months. The healing rate was 100%. A limitation of this study consists in the small number of patients. CONCLUSION Sclerotherapy with ethanol 96% is a useful method for the treatment of ABC. It is a minimally invasive method, with no major complications, which lowers the risks of open surgical intervention and has a good rate of success.
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Affiliation(s)
- Alexandru Ulici
- Department of Pediatric Orthopedic Surgery, Emergency Hospital for Children "Grigore Alexandrescu", 30-32, Iancu de Hunedoara Bvd, 011733, Bucharest, Romania. .,Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - Daniel-Catalin Florea
- Department of Pediatric Orthopedic Surgery, Emergency Hospital for Children "Grigore Alexandrescu", 30-32, Iancu de Hunedoara Bvd, 011733, Bucharest, Romania
| | - Madalina Carp
- Department of Pediatric Orthopedic Surgery, Emergency Hospital for Children "Grigore Alexandrescu", 30-32, Iancu de Hunedoara Bvd, 011733, Bucharest, Romania
| | - Alin Ladaru
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Iulia Tevanov
- Department of Pediatric Orthopedic Surgery, Emergency Hospital for Children "Grigore Alexandrescu", 30-32, Iancu de Hunedoara Bvd, 011733, Bucharest, Romania
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17
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Malghem J, Lecouvet F, Vande Berg B. Calcaneal cysts and lipomas: a common pathogenesis? Skeletal Radiol 2017; 46:1635-1642. [PMID: 28616637 DOI: 10.1007/s00256-017-2688-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 05/22/2017] [Accepted: 05/25/2017] [Indexed: 02/02/2023]
Abstract
Calcaneal cysts and lipomas are relatively rare, benign bone lesions. They are similar in many ways, including in their location and radiological appearance, but their content differs. Cysts contain fluid whereas lipomas contain fat, although some lesions may exhibit a mixed content. The pathogenesis of the two entities is the subject of controversy. The theory that calcaneal cysts may result from lipomatous necrosis has been widely suggested in the literature, but no such progression has ever been shown. The contrary hypothesis has also been considered, i.e., that the content of regressing cysts may be replaced by fatty marrow, leading to a lipoma-like appearance. This second theory is based on indirect arguments, notably that lipomas have a similar location to intraosseous calcaneal ganglion cysts that arise from the subtalar joint and that patients are older in cases of calcaneus lipomas than in cases of calcaneus cysts. We offer an additional argument in favor of this hypothesis. We present an original observation of a calcaneal cyst incidentally discovered in a 15-year-old male whose spontaneous evolution 3 and 7 years later revealed progressive replacement of its fluid content by fat.
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Affiliation(s)
- Jacques Malghem
- Département de radiologie et d'imagerie médicale, Université catholique de Louvain, Cliniques universitaires Saint Luc, Avenue Hippocrate 10, 1200, Bruxelles, Belgium.
| | - Frédéric Lecouvet
- Département de radiologie et d'imagerie médicale, Université catholique de Louvain, Cliniques universitaires Saint Luc, Avenue Hippocrate 10, 1200, Bruxelles, Belgium
| | - Bruno Vande Berg
- Département de radiologie et d'imagerie médicale, Université catholique de Louvain, Cliniques universitaires Saint Luc, Avenue Hippocrate 10, 1200, Bruxelles, Belgium
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18
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Abstract
The optimal treatment of aneurysmal bone cyst remains challenging. The aim of this prospective study was to evaluate the results of using bone grafts shaped to the defects caused by aneurysmal bone cysts of upper limb bones. Fifteen patients (12 males and 3 females) with an average age of 12 years (range 6-16 years) were treated for aneurysmal bone cysts of upper limb bones by intralesional resection, argon beam coagulation and shaped bone graft. The grafts were harvested from 14 patients (11 fibulas and 3 iliac bones) and from the mother of one patient (proximal fibula). Osteosynthesis was required to stabilize the graft in four cases. The modified Enneking's scoring system was used for functional evaluation. One patient developed partial recurrence at 6 months and required reoperation. Superficial wound infection was encountered in one patient. Shortening of the humeral segment was seen in two patients (1 and 1.5 cm) but without angular deformity. After a mean follow-up of 45 months (range 24-68 months), the mean functional score was 97.3%. This technique proved to be reliable in obtaining a well reconstructed and growing bone with no or minimal deformity and good function.
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Affiliation(s)
- Mohamed F Mostafa
- Orthopedic Oncology Unit, Department of Orthopedic Surgery, Mansoura University Hospital, 36 Al-Gomhoria Street, P.O. Box 35516, Mansoura, Egypt.
| | - Yasser Y Abed
- Orthopedic Oncology Unit, Department of Orthopedic Surgery, Mansoura University Hospital, 36 Al-Gomhoria Street, P.O. Box 35516, Mansoura, Egypt
| | - Sallam I Fawzy
- Orthopedic Oncology Unit, Department of Orthopedic Surgery, Mansoura University Hospital, 36 Al-Gomhoria Street, P.O. Box 35516, Mansoura, Egypt
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19
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Abstract
Le kyste osseux anévrysmal est une tumeur bénigne pouvant toucher tous les os du corps. Rare au niveau de la base du crane, il siège habituellement au niveau des os longs. Nous rapportons l'observation clinique d'un homme de 44 ans suivi depuis 9 mois pour une masse du basisphenoide étiquetée à tort comme un macroadénome invasif à prolactine et pour lequel il fut mis sous traitement (agonistes dopaminergiques). Nous avons redressé le diagnostic en évoquant le kyste osseux anévrysmal du sphénoïde de par son aspect radiologique en IRM quasi pathognomonique.
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Affiliation(s)
| | - Kaoutar Aammou
- Service Central de Radiologie, Chu Ibn Rochd, Casablanca, Maroc
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20
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Medina J, Rivlin M, Chan J, Beredjiklian PK. Ossified Dorsal Wrist Ganglion Cyst: A Case Report. Arch Bone Jt Surg 2016; 4:399-401. [PMID: 27847858 PMCID: PMC5100461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/07/2016] [Indexed: 06/06/2023]
Abstract
Ganglion cysts are the most common wrist tumors, and 60 -70% originate dorsally from the scapholunate interval. Ossification of these lesions is exceedingly rare, with only one such lesion located in the finger reported in the literature. We present a case of an ossified dorsal wrist ganglion in a 68-year-old woman.
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Affiliation(s)
- Juana Medina
- Ortopedia y traumatología, Fundación Santa Fe de Bogotá, Bogotá, D.C., Cundinamarca, Colombia, USA
| | - Michael Rivlin
- Ortopedia y traumatología, Fundación Santa Fe de Bogotá, Bogotá, D.C., Cundinamarca, Colombia, USA
| | - Joanna Chan
- Ortopedia y traumatología, Fundación Santa Fe de Bogotá, Bogotá, D.C., Cundinamarca, Colombia, USA
| | - Pedro K Beredjiklian
- Ortopedia y traumatología, Fundación Santa Fe de Bogotá, Bogotá, D.C., Cundinamarca, Colombia, USA
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Abstract
Stafne bone cavity is a rare mandibular defect that was first reported by Edward C. Stafne in 1942. It commonly presents with a well-demarcated, asymptomatic, unilateral radiolucency that indicates lingual invagination of the cortical bone. A 52-year-old female patient who with nasal bone fracture, visited the hospital. During facial bone computed tomography (CT) for facial area evaluation, a well-shaped cystic lesion was accidentally detected on the right side of the mandible. Compared to the left side, no swelling or deformity was observed in the right side of the oral lesion, and no signs of deformity caused by mucosal inflammation. 3D CT scans, and mandible series x-rays were performed, which showed a well-ossified radiolucent oval lesion. Axial CT image revealed a cortical defect containing soft tissue lesion, which has similar density as the submandibular gland on the lingual surface of the mandible. The fact that Stafne cavity is completely surrounded by the bone is the evidence to support the hypothesis that embryonic salivary gland is entrapped by the bone. In most cases, Stafne bone cavity does not require surgical treatment. We believe that the mechanical pressure from the salivary gland could have caused the defect.
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Affiliation(s)
- Jae Il Lee
- Department of Plastic and Reconstructive Surgery, Busan Baik Hospital, Inje University School of Medicine, Busan, Korea
| | - Seok Joo Kang
- Department of Plastic and Reconstructive Surgery, Busan Baik Hospital, Inje University School of Medicine, Busan, Korea
| | - Seong Pin Jeon
- Department of Plastic and Reconstructive Surgery, Busan Baik Hospital, Inje University School of Medicine, Busan, Korea
| | - Hook Sun
- Department of Plastic and Reconstructive Surgery, Busan Baik Hospital, Inje University School of Medicine, Busan, Korea
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Erol B, Topkar MO, Aydemir AN, Okay E, Caliskan E, Sofulu O. A treatment strategy for proximal femoral benign bone lesions in children and recommended surgical procedures: retrospective analysis of 62 patients. Arch Orthop Trauma Surg 2016; 136:1051-61. [PMID: 27317344 DOI: 10.1007/s00402-016-2486-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Indexed: 01/28/2023]
Abstract
PURPOSE We aimed to develop a surgical treatment strategy for benign bone lesions of the proximal femur based upon retrospective review of our data in 62 children. METHODS Sixty-two children [38 male, 24 female; median age 9 years (range 5-18 years)] with proximal femoral benign bone lesions were surgically treated between 2005 and 2013. Histopathological diagnoses were simple (31) or aneurysmal (27) bone cysts, and nonossifying fibromas (4). The pathological fracture rate was 77.4 %. Surgical treatment was determined due to four criteria, including patient's skeletal maturity, localization and initial diagnosis of lesion, and amount of bone loss in the femoral neck and lateral proximal femur. Surgical procedure consisted of biopsy, curettage, bone grafting, and internal fixation when required. The median follow-up was 45 months (range 25-89 months). RESULTS Complete clinical recovery was achieved in 56 (90.3 %) patients between 4 and 8 months postoperatively; full weight-bearing and mobilization, without pain and limping, was possible. The median preoperative and postoperative last follow-up Musculoskeletal Tumor Society (MSTS) scores were 13.3 % (range 10-23.3 %) and 96.6 % (range 90-100 %), respectively (p < 0.0001). The pathological fractures were healed in 10 weeks on average (range 8-12 weeks). Fifty-seven (92 %) patients demonstrated complete or significant partial radiographic healing between 5 and 7 months that maintained throughout follow-up. Local recurrence was not observed, and only 1 (1.6 %) patient required reoperation for partial cyst healing. There were 5 (8 %) complications, 1 (1.6 %) of which required reoperation. CONCLUSIONS This treatment strategy can provide good local control and excellent functional and radiological results in the management of benign bone lesions of the proximal femur in children.
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Affiliation(s)
- Bulent Erol
- Orthopedics and Traumatology Department, Marmara University Hospital, Fevzi Cakmak Mh. Muhsin Yazicioglu Cd. No:10 34899 Ust Kaynarca, Pendik, Istanbul, Turkey
| | - Mert Osman Topkar
- Orthopedics and Traumatology Department, Marmara University Hospital, Fevzi Cakmak Mh. Muhsin Yazicioglu Cd. No:10 34899 Ust Kaynarca, Pendik, Istanbul, Turkey.
| | - Ahmet Nadir Aydemir
- Orthopedics and Traumatology Department, Marmara University Hospital, Fevzi Cakmak Mh. Muhsin Yazicioglu Cd. No:10 34899 Ust Kaynarca, Pendik, Istanbul, Turkey
| | - Erhan Okay
- Orthopedics and Traumatology Department, Marmara University Hospital, Fevzi Cakmak Mh. Muhsin Yazicioglu Cd. No:10 34899 Ust Kaynarca, Pendik, Istanbul, Turkey
| | - Emrah Caliskan
- Orthopedics and Traumatology Department, Marmara University Hospital, Fevzi Cakmak Mh. Muhsin Yazicioglu Cd. No:10 34899 Ust Kaynarca, Pendik, Istanbul, Turkey
| | - Omer Sofulu
- Orthopedics and Traumatology Department, Marmara University Hospital, Fevzi Cakmak Mh. Muhsin Yazicioglu Cd. No:10 34899 Ust Kaynarca, Pendik, Istanbul, Turkey
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23
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Satake H, Takahara M, Takagi M. Osteochondritis Dissecans of the Humeral Capitellum Associated with a Large Subchondral Bone Cyst: Two Cases Report. J Hand Surg Asian Pac Vol 2016; 21:257-61. [PMID: 27454643 DOI: 10.1142/s2424835516720097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
We report two rare cases of osteochondral dissecans of the humeral capitellum, each associated with a large subchondral cyst. The procedure employed for reconstruction of the massive bone defect yielded excellent clinical and radiological outcomes in both cases, and therefore seems promising for treatment of osteochondritis dissecans.
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Affiliation(s)
- Hiroshi Satake
- 1 Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Japan
| | - Masatoshi Takahara
- 2 Center for Hand, Elbow and Sports Medicine, Izumi Orthopedics Hospital, Sendai, Japan
| | - Michiaki Takagi
- 1 Department of Orthopaedic Surgery, Yamagata University Faculty of Medicine, Japan
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24
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Langston JR, DeHaan AM, Huff TW. Staged total hip arthroplasty in a patient with hip dysplasia and a large pertrochanteric bone cyst. Arthroplast Today 2016; 2:57-61. [PMID: 28326400 DOI: 10.1016/j.artd.2016.03.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 03/23/2016] [Accepted: 03/28/2016] [Indexed: 12/26/2022] Open
Abstract
Hip arthroplasty in young patients requires thoughtful preoperative planning. Patients with proximal femoral bone loss complicate this planning and may require a staged procedure to optimize implant insertion. We report on a case of a 26-year-old woman with secondary hip arthritis from developmental dysplasia of the hip and a large pertrochanteric bone cyst that was treated with staged total hip arthroplasty. The cyst was decompressed and filled with an osteoconductive and osteoinductive bone graft substitute called EquivaBone. One year later, the patient underwent a successful primary total hip arthroplasty. Fifteen-month follow-up after her hip replacement revealed resolution of postoperative pain and significant functional improvement.
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25
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Abstract
Stafne's bone cavity is a rare, asymptomatic, unilateral oval shaped radiolucent defect in the posterior region of the mandible below the inferior alveolar canal. The prevalence ranges from 0.10% to 0.48% and more common in males. It is mostly an incidental finding on panoramic radiograph. This radiolucency is considered to be a deformity of the medial cortex. This article presents five rare cases of Stafne's bone cavity which were referred for opinion or wrongly diagnosed by practicing health professionals as jaw tumour leading to psychological distress in these patients. This article also focuses on reviewing the published literature, differential diagnosis along with use of various diagnostic imaging resources for this bone defect and to add five new Indian cases to the literature.
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Affiliation(s)
- Chandramani Bhagwan More
- Professor and Head, Department of Oral Medicine and Radiology, K.M. Shah Dental College & Hospital, Sumandeep Vidyapeeth University , Piparia, Vadodara, Gujarat, India
| | - Sunanda Das
- Ex- Postgraduate Student, Department of Oral Medicine & Radiology, K.M. Shah Dental College & Hospital, Sumandeep Vidyapeeth University , Piparia, Vadodara, Gujarat, India
| | - Swati Gupta
- Ex- Postgraduate Student, Department of Oral Medicine & Radiology, K.M. Shah Dental College & Hospital, Sumandeep Vidyapeeth University , Piparia, Vadodara, Gujarat, India
| | - Pranay Patel
- Postgraduate Student (3 year), Department of Oral Medicine & Radiology, K.M. Shah Dental College & Hospital, Sumandeep Vidyapeeth University , Piparia, Vadodara, Gujarat, India
| | - Nairita Saha
- Postgraduate Student, Department of Oral Medicine & Radiology, K.M. Shah Dental College & Hospital, Sumandeep Vidyapeeth University , Piparia, Vadodara, Gujarat, India
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26
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Chen Y, Huang YC, Lu WW. Is subchondral bone mineral density associated with nocturnal pain in knee osteoarthritis patients? Osteoarthritis Cartilage 2015; 23:2297-2298. [PMID: 26162803 DOI: 10.1016/j.joca.2015.05.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 05/21/2015] [Indexed: 02/02/2023]
Affiliation(s)
- Y Chen
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The University of Hong Kong, Hong Kong; Bone Bioengineering Laboratory, Department of Biomedical Engineering, Columbia University, New York, USA.
| | - Y-C Huang
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - W W Lu
- Department of Orthopaedics and Traumatology, Faculty of Medicine, The University of Hong Kong, Hong Kong; Center for Human Tissue and Organs Degeneration and Shenzhen Key Laboratory of Marine Biomedical Materials, Shenzhen Institutes of Advanced Technology, CAS, China; Shenzhen Key Laboratory for Innovative Technology in Orthopaedic Trauma, The University of Hong Kong Shenzhen Hospital, China.
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27
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Burnett WD, Kontulainen SA, McLennan CE, Hazel D, Talmo C, Hunter DJ, Wilson DR, Johnston JD. Response to Letter to the Editor: 'Is subchondral bone mineral density associated with nocturnal pain in knee osteoarthritis patients?'. Osteoarthritis Cartilage 2015; 23:2299-2301. [PMID: 26162805 DOI: 10.1016/j.joca.2015.06.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 06/29/2015] [Indexed: 02/02/2023]
Affiliation(s)
- W D Burnett
- Division of Biomedical Engineering, University of Saskatchewan, Saskatoon, SK, Canada
| | - S A Kontulainen
- Division of Biomedical Engineering, University of Saskatchewan, Saskatoon, SK, Canada; College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - C E McLennan
- Division of Research, New England Baptist Hospital, Boston, MA, USA
| | - D Hazel
- Division of Research, New England Baptist Hospital, Boston, MA, USA
| | - C Talmo
- Division of Research, New England Baptist Hospital, Boston, MA, USA
| | - D J Hunter
- Institute of Bone and Joint Research, University of Sydney, Sydney, NSW, Australia
| | - D R Wilson
- Department of Orthopaedics and Centre for Hip Health and Mobility, University of British Columbia and Vancouver Costal Health Research Institute, Vancouver, BC, Canada
| | - J D Johnston
- Division of Biomedical Engineering, University of Saskatchewan, Saskatoon, SK, Canada; Department of Mechanical Engineering, University of Saskatchewan, SK, Canada.
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28
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Kaneshiro S, Shi K, Ebina K, Yukioka M, Yoshikawa H, Murata N. Multiple subcutaneous xanthogranuloma at juxta-articular sites with bone cystic changes resembling rheumatoid arthritis: A case report. Mod Rheumatol 2015; 28:361-364. [PMID: 26474323 DOI: 10.3109/14397595.2015.1109763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Xanthogranuloma is a benign disease represented as histiocytosis with lipoid deposition which usually occurs in children, but rarely in adults. We report a case of an adult patient with multiple subcutaneous xanthogranuloma at juxta-articular sites with bone cystic changes, manifesting similar clinical profiles to rheumatoid arthritis. Although very rare, we should consider the possibility of xanthogranulomatosis in the diagnosis of rheumatoid arthritis, especially in atypical cases.
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Affiliation(s)
- Shoichi Kaneshiro
- a Department of Orthopedic Surgery , Japan Community Healthcare Organization Osaka Hospital , Fukushima-ku , Osaka , Japan
| | - Kenrin Shi
- b Department of Orthopedic Surgery , Osaka University Graduate School of Medicine , Suita, Osaka , Japan , and.,c Department of Rheumatology , Yukioka Hospital , Kita-ku , Osaka , Japan
| | - Kosuke Ebina
- b Department of Orthopedic Surgery , Osaka University Graduate School of Medicine , Suita, Osaka , Japan , and
| | - Masao Yukioka
- c Department of Rheumatology , Yukioka Hospital , Kita-ku , Osaka , Japan
| | - Hideki Yoshikawa
- b Department of Orthopedic Surgery , Osaka University Graduate School of Medicine , Suita, Osaka , Japan , and
| | - Norikazu Murata
- c Department of Rheumatology , Yukioka Hospital , Kita-ku , Osaka , Japan
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29
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Zaghloul A, Haddad B, Khan W, Grimes L, Tucker K. A Novel Minimally Invasive Technique for Treatment of Unicameral Bone Cysts. Open Orthop J 2015; 9:475-9. [PMID: 26587064 PMCID: PMC4645971 DOI: 10.2174/1874325001509010475] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 04/14/2015] [Accepted: 05/24/2015] [Indexed: 01/30/2023] Open
Abstract
Management of unicameral bone cysts (UBC) remain controversial. These cysts seldom heal spontaneously or even after pathological fracture. Sometimes these cysts can be very large and incredibly troublesome to the patient. Various treatments exist with variable success rates. We present our experience of treating these lesions by continuous drainage. Over a seven year period, six patients with unicameral bone cysts were treated by inserting a modified drain into the wall of the cyst. The aim of surgery was to place the drain in a dependent area of the cyst, through the cortex allowing for continuous drainage. This was achieved through a small incision under radiographic control. A cement restrictor (usually used for femoral canal plugging during total hip replacements) was modified and inserted to prevent closure of the drain site. A redivac drain was passed through the plug into the cyst. The drain was left in place for a week to establish an epithelialized pathway which hopefully would remain patent, into the subcutaneous tissues, after the drain had been removed. There were four males and two females in the group and the age range was 6 -12 years. Four of the lesions were in the upper humerus, one in the proximal femur and the other one in the proximal tibia. Healing was rated according to the modified Neer classification. Grade 1 (healed) and Grade 2 (healed with defect) was defined as excellent outcome. Persistent /Recurrent cysts (Grade 3 and 4) were noted as unsatisfactory. Five cases were completely healed. Only one had a further fracture and there were no recurrent fractures. All the patients reported complete comfort and they all were able to re-engage in recreational activities without restriction. We think that reducing the intra-medullary pressure in these lesions will lead to healing. We report a safe and minimally invasive technique for the management of UBC.
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Affiliation(s)
- Ahmed Zaghloul
- West Suffolk Hospital, Hardwick Lane, Bury St Edmunds, Suffolk IP33 2QZ, UK
| | - Behrooz Haddad
- West Suffolk Hospital, Hardwick Lane, Bury St Edmunds, Suffolk IP33 2QZ, UK
| | - Wasim Khan
- University College London, Institute of Orthopaedic and Musculoskeletal Sciences, Royal National Orthopaedic Hospital Stanmore Middlesex, HA7 4LP, UK
| | - Lisa Grimes
- West Suffolk Hospital, Hardwick Lane, Bury St Edmunds, Suffolk IP33 2QZ, UK
| | - Keith Tucker
- Norfolk and Norwich University Hospitals, Norwich, NR4 7UY, UK
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30
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Boubbou M, Atarraf K, Chater L, Afifi A, Tizniti S. Aneurysmal bone cyst primary--about eight pediatric cases: radiological aspects and review of the literature. Pan Afr Med J 2013; 15:111. [PMID: 24244797 PMCID: PMC3828064 DOI: 10.11604/pamj.2013.15.111.2117] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2012] [Accepted: 05/06/2013] [Indexed: 11/29/2022] Open
Abstract
The aneurysmal bone cyst is a pseudotumoral lesion that can take several aspects. This is a rare lesion representing 1% of bone tumors. It appears usually during the first 30 years of life. The pathogenesis is that of a process of “dysplasia/hyperplasia”, favored by a circulatory deficiency and hemorrhage within the lesion and the phenomena of osteoclasis. The objective of this work is to illustrate with analysis, the specific forms and atypical aneurysmal bone cyst which often pose a diagnostic challenge requiring radiological investigation with histological confirmation. We report eight pediatric cases of aneurysmal cysts collected over a period of 3 years, 3 boys and 5 girls. All patients had standard radiographs. MRI was performed in three patients. The diagnosis was confirmed histologically. The atypia has been in the seat: fibula (1 case), metaphyseal (2 cases), diaphyseal (4 cases) and metatarsal (1 case). Aneurysmal bone cyst is a rare benign tumor with predilection to the metaphysis of long bones. Atypical forms even fewer are dominated by the atypical seat.
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31
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Suresh SS. Orthopaedic Manifestations of Date Thorn Injury: Case series. Sultan Qaboos Univ Med J 2008; 8:347-352. [PMID: 21748083 PMCID: PMC3074855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2008] [Accepted: 08/18/2008] [Indexed: 05/31/2023] Open
Abstract
Date palm thorn injuries are common in Middle Eastern countries where there are many date palm plantations. Most of the injuries happen to workers in the plantation or to children. Injuries, if detected, can be treated without subsequent complications, but in children the diagnosis can very easily be missed resulting in late complications. The hand, being the most exposed part of the body, is the most affected. Embedded thorns can produce lesions mimicking those of osteomyelitis. The foot is exposed to injuries in people who walk barefoot in the plantations. The author presents five cases of date thorn injury which presented with late complications. All three patients with hand injuries had periostitis, and one of them had an intraosseous thorn producing osteomyelitis. Two patients presented with osteolytic lesions of the metatarsals with intraosseous thorn in one patient. All cases recovered completely leaving behind no sequlae of the bony infection.
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32
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Abstract
Hydatid disease is caused by the tapeworm Echinococcus. Genus Echinococcus has different species including Echinococcus vogeli, Echinococcus granulosus and Echinococcus multilucularis. Echinococcus granulosus is the most common cause of hydatid disease in humans. This disease occurs either through direct ingestion of parasite eggs from contact with infected dogs or indirectly from the ingestion of contaminated water or food.Infestation of hydatid disease in humans most commonly occurs in the liver (55-70%), followed by the lungs (18-35%). Bone hydatidosis however is very rare (3%). We present herein a case of hydatid cyst of the fibula, which is an uncommon site for the occurrence of this disease.
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Affiliation(s)
- Hamidreza Arti
- Department of Orthopedic Surgery, Kashani Hospital, Faculty of Medicine, Shahrekord University of Medical sciences, Shahrekord, Iran,Correspondence: Dr. Hamidreza Arti, Iran-Isfahan-Khyaban, Shykh Sadogh, Shomali Khyaban Pepsicola No: 88, Postal Code 8163984811, Iran. E-mail:
| | - Hossein Yousofi Darani
- Department of Parasitology, Kashani Hospital, Faculty of Medicine, Shahrekord University of Medical sciences, Shahrekord, Iran
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