Related Experiment Videos
[Juvenile bone cysts. Relative value and therapy results of cortisone injections]
Insights
Cortisone injections effectively treat unicameral bone cysts in children and adolescents, with 92% healing rates. This minimally invasive, low-cost method is a viable alternative to surgery for these bone lesions.
Area of Science:
- Pediatric Orthopedics
- Skeletal Radiology
- Pediatric Bone Tumors
Background:
- Unicameral bone cysts (UBCs) are benign bone lesions commonly affecting children and adolescents.
- Historically, surgical interventions like curettage and bone grafting were standard treatments.
- Pathological fractures are a common complication of UBCs, occurring in 70% of cases in this study.
Purpose of the Study:
- To evaluate the efficacy and outcomes of treating unicameral bone cysts in pediatric patients.
- To compare the effectiveness of cortisone injections with previous surgical methods.
- To assess the complication rates and cost-effectiveness of the treatment protocol.
Main Methods:
- Retrospective analysis of 71 children and adolescents treated for unicameral bone cysts between 1982 and 1992.
- Introduction of cortisone injections as a primary treatment modality since 1982, replacing surgical methods.
- Radiological diagnosis was standard, with biopsies performed selectively after 1986 due to diagnostic uncertainties.
Main Results:
- The proximal humerus was the most common site (51%), followed by the femur (34%) and tibia (10%).
- Cortisone injections resulted in a 92% healing rate (complete or with residuals) according to the Neer classification.
- Additional osteosynthesis was required for pathological fractures of the femoral neck.
Conclusions:
- Cortisone injections represent a highly effective, minimally invasive, and cost-effective treatment for unicameral bone cysts in pediatric patients.
- The treatment protocol demonstrated low morbidity and favorable outcomes, supporting its continued use.
- The study highlights a shift in treatment paradigms from surgical intervention to less invasive methods for UBCs.
Abstract:
Seventy-one children and adolescents with unicameral bone cysts were treated between 1982 and 1992. Fifty-one percent were in the proximal humerus, 34% in the femur, 10% in the tibia, and only 5% in other sites. Until 1986 biopsies were routinely done. Since then, only selected cases have been biopsied because of uncertainty in the radiological diagnosis. In 70% the diagnosis was a pathological fracture as a result of the cyst. Cortisone injections were introduced in 1982. It replaced currettage and bone grafting, which was the routine treatment until then. Ninety-two percent of the cysts healed or healed with residuals according to the Neer classification. Additional osteosynthesis was done in pathological fractures of the femoral neck. The results are achieved with little morbidity, and low cost which justifies continuation of this treatment protocol.