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[Treatment of simple bone cysts with methylprednisolone acetate in children]
Güney Yilmaz1, M Cemalettin Aksoy, Ahmet Alanay
1Department of Orthopedics and Traumatology (Ortopedi ve Travmatoloji Anabilim Dali), Medicine Faculty of Hacettepe University, 06100 Sihhiye, Ankara, Turkey.
Insights
Steroid injections effectively treated simple bone cysts in children, with 84.6% of patients showing satisfactory healing. This minimally invasive approach is a viable alternative to more aggressive treatments for pediatric bone cysts.
Area of Science:
- Orthopedics
- Pediatric Medicine
- Radiology
Background:
- Simple bone cysts are benign bone lesions common in children.
- Treatment options for simple bone cysts range from observation to surgical intervention.
- Steroid injections offer a less invasive therapeutic option.
Purpose of the Study:
- To evaluate the efficacy and outcomes of methylprednisolone acetate injections for treating simple bone cysts in pediatric patients.
- To assess the healing rates and patient satisfaction following steroid injection therapy.
Main Methods:
- Thirteen pediatric patients with simple bone cysts received methylprednisolone acetate injections using a two-needle technique.
- Injections were administered at six-week intervals, with a maximum of three treatments per patient.
- Radiographic monitoring and assessment using the Neer classification were performed over a mean follow-up of five years.
Main Results:
- Complete healing was observed in 38.5% of patients, with an additional 46.2% showing healing with residual lesions.
- Overall satisfactory results were achieved in 84.6% of cases.
- No procedure-related complications were reported, with one case of non-response and one recurrence.
Conclusions:
- Methylprednisolone acetate injections provide a satisfactory treatment outcome for simple bone cysts in children.
- Steroid injection therapy is a viable and less aggressive alternative to surgical interventions.
- This minimally invasive method warrants consideration for pediatric simple bone cysts.
Objectives:
Steroid injections represent one of the simple treatment alternatives for simple bone cysts in pediatric age group. The aim of this study was to evaluate the results of steroid injections in the treatment of simple bone cysts.
Methods:
Thirteen children (9 boys, 4 girls; mean age 9 years; range 4 to 14 years) with simple bone cysts were treated primarily with injection of methylprednisolone acetate with the use of the two-needle technique. The cysts were localized in the proximal humerus (n=7), femoral intertrochanteric region (n=4), and the proximal one-third of the femur (n=1). Four patients had fractures before treatment. Each patient received a maximum of three injections at six-week intervals, each consisting of 120-160 mg of methylprednisolone acetate. The patients were monitored by plain radiographs obtained in the sixth week, third month, sixth month, and at the end of a year followed by annual radiographic evaluations. Cyst healing was assessed according to the Neer classification. The mean follow-up was five years (range 1 to 11 years).
Results:
Treatment with methylprednisolone acetate resulted in complete healing in five patients (38.5%) and healing with residual lesions in six patients (46.2%). One patient (7.7%) did not respond to steroid treatment and one patient developed recurrence. The results were satisfactory (84.6%) in patients with complete healing and healing with residual lesions, and unsatisfactory in two patients (15.4%). No procedure-related complications were encountered.
Conclusion:
Our results suggest that treatment with steroid injections offers satisfactory outcome in simple bone cysts in children, and thus, is worthy of consideration before more aggressive methods are to be applied.
