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[Fractures in benign bone cysts].

H Röhner, U Pfister, P J Meeder

    Aktuelle Traumatologie
    |April 1, 1984
    PubMed
    Summary
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    Segmental resection with bone grafting and osteosynthesis effectively treats active, recurrent, or fractured solitary bone cysts, preventing recurrence. Curettage alone often leads to poor outcomes and repeat cysts.

    Area of Science:

    • Orthopedics
    • Surgical Oncology
    • Pediatric Orthopedics

    Background:

    • Solitary bone cysts (SBCs) and aneurysmal bone cysts (ABCs) are benign bone lesions with varying clinical presentations.
    • Distinguishing between active and inactive SBCs is crucial for determining prognosis and guiding treatment strategies.
    • Fractured cysts and those near joints present unique management challenges.

    Purpose of the Study:

    • To report on the etiology, clinical manifestations, radiographic appearance, and histological variations of SBCs and ABCs.
    • To evaluate the long-term efficacy of surgical interventions for complex bone cyst cases.
    • To compare outcomes of different treatment modalities for solitary bone cysts.

    Main Methods:

    • Retrospective analysis of patients with fractured SBCs and ABCs treated since 1973.

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  • Surgical treatment involved segmental resection, rib interposition, bone grafting (homologous or autogenous cancellous), and plate osteosynthesis for specific cases.
  • Comparison of outcomes between surgical resection and simple curettage for active SBCs.
  • Main Results:

    • Segmental resection with bone grafting and osteosynthesis demonstrated a zero-recidivism rate in treated patients.
    • Simple curettage of active SBCs frequently resulted in recurrence and unsatisfactory functional outcomes.
    • Management of fractured, recurrent, and large cysts near joints was highly successful with the described surgical approach.

    Conclusions:

    • Surgical management including segmental resection, bone grafting, and osteosynthesis is a highly effective treatment for complex solitary bone cysts, preventing recurrence.
    • Simple curettage is an insufficient treatment for active solitary bone cysts, often leading to poor functional results and recurrence.
    • Further critical evaluation of local corticoid injections for bone cyst treatment is warranted.