This treatment strategy can provide good local control and excellent functional and radiological results in the management of benign bone lesions of the proximal femur in children.
Complete cyst healing and satisfactory functional results can be obtained by curettage grafting and intramedullary decompression. This technique restores bone integrity by allowing early motion and prevents refracture and subsequent deformity in the majority of patients.
The objectives of this retrospective study were to evaluate long-term functional and radiological outcomes of 102 dislocated hips of 79 patients treated with the modified medial approach and to compare them with respect to both of our short-term and mid-term outcomes and also with the current literature. The mean age at operation was 11.3±4.3 months (range: 3–18 months), with a minimum follow-up of 15 years (range: 15–23 years). It was determined that 94.1% of mean hip scores were either good or excellent. Avascular necrosis, subluxation/redislocation, and secondary surgeries were 14.8, 6.9, and 7.8%, respectively. We believe this modified procedure requiring no routine arthrotomy is safe and effective.
The aim of this study was to evaluate functional and radiological results, tumor control, and complications of the surgical treatment of aneurysmal bone cysts (ABCs) in children by extended curettage using a mechanical burr and cauterization, grafting, and internal fixation in specific locations. Sixty-four children [38 males, 26 females, median age=10 years (range, 5-18 years)] with active or aggressive ABCs of long and flat bones were subjected to a median follow-up of 66 months (range, 28-130 months) following surgical treatment. The pathological fracture rate was 72%. Surgical procedures included intralesional extended curettage (92%) or en-bloc resection (8%). Internal fixation was required in 53%. The pathological fractures healed successfully in 8-12 weeks. The median Musculoskeletal Tumor Society (MSTS) score at the last follow-up was 95% (range, 55-100%). Treatment failure (partial healing/recurrence) and complication rates following extended curettage were 7 and 5.2%, respectively. Statistically, the only parameter affecting partial healing and local recurrence was proximity of the lesion to the growth plate (P=0.011). Extended curettage using a mechanical burr and cauterization, grafting, and internal fixation in specific locations can promote healing in most cases of ABC, with low recurrence and complication rates.
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