[Comparison of the treatment of juvenile bone cysts by corticoids and bone grafting.]

Juvenile bone cysts are frequent affections. Their treatment develops in the direction of the application of less invasive methods. The authors treated 43 patients with this diagnosis in the period of six years. The aim of the article is to specify the criteria for the indication of two most frequently used methods of treatment of juvenile bone cysts, namely. a)percutaneous instillation of methylprednisone acetate (MPA); b)surgical curettage and bone grafting of the cyst by an autograft or allograft. They state that significant for the prognosis of the juvenile bone cyst are: 1. the age of the patient, 2. activity or latency of the juvenile bone cyst, 3. its location. Worse results were recorded in the treatment of active cysts. The highest incidence of active cysts falls into the period of growth acceleration, i. e. between the seventh and tenth year. Worse results were achieved in the treatment of younger patients. In younger patients with juvenile bone cyst they recommend as the method of choice a less invasive MPA treatment. If the cyst does not heal after instillation repeated three times, the juvenile bone cyst is MPA resistant and it is necessary to change the method of treatment. In older patients with large cysts (femur, tibia) the authors recommend to apply bone grafting as the primary method. Worse results in both methods were recorded on weight bearing bones (a more frequent incidence of MPA resistant juvenile bone cysts). In MPA resistant juvenile bone cysts the authors had to use bone grafting five times more often due to the persisting difficulties. Key words: juvenile bone cyst, methylprednisone acetate, bone graft.