Comparison of three treatment methods for simple bone cyst in children

Abstract

Background The unicameral bone cyst (UBC) is a kind of benign tumor whose clinical treatments and efficacy are controversial. The purpose of this study was to evaluate the efficacy of the elastic stable intramedullary nail (ESIN), the injection of autologous bone marrow (ABM), and the combination of ESIN and ABM in the treatment of bone cyst in children. Methods Eighty-three cases with simple bone cyst were analyzed retrospectively. Twenty-eight cases were treated with ABM. Twenty-eight cases were treated with ESIN. Twenty-seven cases were treated with ABM and ESIN. All cases were diagnosed through X-ray, CT, or MRI scans. For the suspicious ones, the pathological biopsy was performed for an accurate diagnosis. X-ray examinations were carried out for the postoperative follow-up. Capanna criteria for bone cyst was used for postoperative evaluation of three methods. Results All cases accomplished the follow-up. The effective rate of the ABM + ESIN group was significantly higher than that of the ABM group (P < 0.05), and the cure rates of the ESIN group and the ABM + ESIN group were higher than that of the ABM group (P < 0.05, respectively). The cure time in the ESIN group was lower than that of the other two groups (P < 0.05, respectively). The times for admission were 2.0 ± 0.0 in the ESIN group, 5.7 ± 1.9 in the ABM group, and 4.7 ± 2.4 in the ABM + ESIN group (P < 0.05 when compared with each other). Conclusions The method of ABM combined with ESIN for children’s bone cyst has the highest effective rate and curative rate. For the individual method, ESIN has a higher effective rate and curative rate than that of ABM. Meanwhile, it has the fewest time of hospitalization.

Risk factors for pathological fractures of simple bone cysts of the humerus in children: a retrospective cohort study

“…Such lesions will gradually separate with age, and the cyst may eventually heal itself and be replaced by normal bone tissue ( 10 ). Assessing the risk of pathological fracture is the most important part of clinical treatment and an important determining factor of surgical intervention ( 11 ).…”

Treatment and Outcomes of 4,973 Unicameral Bone Cysts

“…Similarly, treatment outcomes of 1,829 patients managed with injection were described in 43 studies 1,3-6,10,16,21,25,27,29,30,38,43,46,50,54,56,60,61,69,70,73-75,78,81,83,87,88,91,92,94,95,98-104,106,108 . Among these, 39 studies with a total 1,631 patients with UBCs described whether decompression of the cyst wall was performed in addition to treatment with injection 1,3-6,10,16,21,27,29,30,32,43,45,46,50,54,56,60,61,69,70,73,74,78,81,83,87,88,91,92,94,95,97,99,101-103,106,108 . Outcomes of patients treated with curettage were described in 61 studies 1,3,4,7,8,17-20,23,24,26,28,31,34,35,37,39,41-44,47,48,…”

“…A total of 4,973 patients with UBCs from 109 studies were included in our systematic review 1,3-10,15-40,41-70,71-110,111-115 . The number of cysts taken from each study ranged from 10 19,38,57,100,105 to 319 104 (Supplementary Table 2).…”

What’s new in musculoskeletal oncology

“…Various treatment options for solitary bone cysts have been reported to date, including allograft or autograft bone grafting following curettage, injection of autogenous bone marrow or steroids, and insertion of an elastic stable intramedullary nail. In a retrospective study, Zhang et al reported that the complete cure rate according to the Capanna criteria of autogenous bone marrow injection combined with an elastic stable intramedullary nail, elastic stable intramedullary nail alone, and autogenous bone marrow injection alone were 96 %, 82 %, and 46 %, respectively [ 24 ]. Zhang et al reported that the complete cure rate of steroid injection combined with an elastic stable intramedullary nail was 78 % [ 25 ].…”