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Treatment of the pathologic fractures through unicameral bone cysts in children


Authors: Pavel Šponer;  Karel Urban;  David Pellar;  Tomáš Kučera;  Karel Karpaš
Authors‘ workplace: Department of Orthopaedic Surgery, University Hospital, Hradec Králové ;  Ortopedická klinika LF UK a FN, Hradec Králové
Published in: Úraz chir. 15., 2007, č.1

Overview

PURPOSE OF THE STUDY:
The aim of this study is the evaluation of children with pathologic fractures through unicameral bone cysts treated at our department.

MATERIAL AND METHODS:
Twenty-two boys and seven girls operated on between 1999 and 2004 for unicameral bone cyst. Fifteen boys and one girl with pathologic fracture through bone cyst were included in this study. Twenty-two cases of pathologic fracture were identified in patients younger or equal to 16 years old (2 repeated pathologic fractures were recorded in 4 children and 3 repeated pathologic fractures in one patient). The primary cyst location were the proximal humerus in 11 patients, the humeral diaphysis in 1 case, the proximal femur and the distal tibia in 2 cases each. The patients were followed up for an average of 6 years (range, 18 months – 9 years). Radiological evaluation was based on standard X-ray images assessed according to the classification system of Neer.

RESULTS:
The clinical examination showed that all patients were free from subjective complaints. No inflammatory changes of soft tissue were found. Both passive and active motion of the adjacent joints was possible in the full range and the treated limb retained its complete function in all patients. X-ray examination showed excellent results, i.e., no residuum or cysts recurrence, in 11 cases. A residual lesion was present in 5 patients with active unicameral bone cyst of proximal humerus.

CONCLUSIONS:
Specific treatment of the unicameral bone cyst is delayed until the fracture is well healed. However, if the fracture is located in a weightbearing bone, the operative management of the fracture and lesion simultaneously is required.

Key words:
unicameral bone cyst, pathologic fracture, operative management.


Sources

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