Pathological Fractures in Aneurysmal Bone Cysts: A Systematic Review
Doriana Di Costa1,2, Elena Gabrielli1,2, Mariagrazia Cerrone1,2
1Department of Orthopaedics, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
Journal of Clinical Medicine
|May 11, 2024
Summary
Surgical management for pathological fractures in aneurysmal bone cysts (ABCs) lacks standard guidelines. Curettage was the most common surgery, but patient factors are crucial for optimal treatment decisions.
Area of Science:
- Orthopedic Surgery
- Bone Pathology
- Oncology
Background:
- Aneurysmal bone cysts (ABCs) are benign vascular bone lesions.
- Pathological fractures occur in approximately 8% of ABC cases.
- Optimal treatment for ABC-related fractures remains debated.
Purpose of the Study:
- To systematically review surgical treatments for pathological fractures in ABCs.
- To clarify the best surgical approach for these complex cases.
- To inform clinical decision-making and guideline development.
Main Methods:
- Systematic literature review following PRISMA guidelines.
- Searches conducted in PubMed, MEDLINE, and Cochrane Library.
- Analysis of 37 relevant studies involving 140 patients.
Main Results:
- Curettage was performed in 88.6% of patients; en bloc resection in 10.7%.
- Surgical fixation (synthesis) was used in 47% of cases.
- Complications occurred in 20.7% of patients.
Conclusions:
- Treatment for pathological fractures in ABCs necessitates individualized assessment.
- Key factors include patient age, growth plate status, lesion location, and surgeon expertise.
- Further research may help establish standardized treatment protocols.
