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TREATMENT OF UNICAMERAL BONE CYSTS IN CHILDREN: A COMPARATIVE STUDY
Bojan Bukva1, Goran Vrgoč1, Dušan Abramović1
11University Children's Hospital, Belgrade, Serbia; 2Faculty of Medicine, University of Belgrade, Belgrade, Serbia;3Department of Orthopedic Surgery, Sveti Duh University Hospital, Zagreb, Croatia; 4Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia; 5Department of ENT and Head and Neck Surgery, Sveti Duh University Hospital, Zagreb, Croatia; 6Department of Traumatology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.
Insights
Unicameral bone cysts (UBC) in children require effective treatment. Open surgery offers complete healing, while intracystic injections are a viable initial option for these benign bone lesions.
Area of Science:
- Orthopedic Surgery
- Pediatric Oncology
- Skeletal Radiology
Background:
- Unicameral bone cysts (UBC) are common benign bone lesions in pediatric patients.
- The etiology of UBC remains unclear, and treatment protocols lack consensus.
- Evaluating different therapeutic approaches is crucial for optimal patient outcomes.
Purpose of the Study:
- To assess the efficacy of three distinct treatment modalities for pediatric UBC.
- To compare outcomes including cyst healing and hospitalization duration.
- To identify the most effective treatment strategy for UBC.
Main Methods:
- A retrospective study of 129 pediatric patients with UBC over 8 years.
- Comparison of intracystic methylprednisolone acetate injection, curettage with bone grafting, and osteoinductive procedures.
- Analysis of parameters: gender, age, cyst characteristics, fracture history, healing, complications, and hospitalization.
Main Results:
- Statistically significant differences in cyst healing and hospitalization were observed between treatment groups.
- Open surgical procedures (curettage/bone grafting and osteoinductive) showed better healing rates than injections.
- Intracystic methylprednisolone acetate injection demonstrated effectiveness as an initial treatment approach.
Conclusions:
- Complete healing of UBC is best achieved through open surgical interventions.
- Intracystic methylprednisolone acetate injection is a suitable option for the initial management of UBC.
- Further research may refine treatment algorithms for pediatric bone cysts.
Abstract:
Unicameral bone cysts (UBC) are benign bone tumor-like lesions. Mostly they are located in the metaphyseal-diaphyseal region of long bones in children and adolescents. The etiology of UBC is still unclear. There is no consensus about the protocol of UBC treatment. The aim of this study was to evaluate the effectiveness of three different techniques for the treatment of UBC. This study included 129 pediatric patients with UBC treated at University Children's Hospital in Belgrade during the 8-year period. The mean follow up was 7.14 years. The following parameters were observed: gender, age, site, length of cyst, cyst index, cortical thickness, presentation of pathologic fracture, healing of cyst, treatment complications and length of hospitalization. These parameters were correlated to three treatment modalities, i.e. intracystic methylprednisolone acetate injection (group 1), curettage with bone grafting (group 2) and osteoinductive procedure using demineralized bone matrix (group 3). We found statistically significant differences in healing of the cysts and length of hospital treatment between groups 1 and 2, and between groups 2 and 3. In conclusion, complete healing of UBC can be achieved only using open surgery procedure. Intracystic methylprednisolone acetate instillation can be considered a good option for initial treatment of UBC.
