Flexible intramedullary nailing for unicameral cysts in children's long bones

Abstract

Purpose The purpose of this study was to evaluate the outcome of flexible intramedullary nailing for unicameral bone cysts in terms of function and osseous consolidation. Methods Twenty-two unicameral bone cysts in children's long bones were treated by flexible intramedullary nailing. In 13 cases the bone cyst was diagnosed in a traumatic event leading to a pathologic fracture. Fifteen patients were referred to our clinic after failed conservative treatment. In 16 patients the cyst was located in the humerus, and in 6 patients in the femur. Mean duration of follow-up after surgery was 24 months. Results According to Capanna's criteria healing was obtained in 20 cases with a mean time of 16 months. Sixteen cysts healed completely. Four lesions were classified as grade 2, meaning that residual radiolucencies were radiographically visible at the latest follow-up. Two recurrences of humeral cysts were seen at 16 and 18 months postoperatively. The complication rate was minimal. Conclusion Due to the immediate stabilization of the lesion aftercare becomes facile. This method allows prompt mobilization and early weight bearing without the necessity of a plaster cast. Further it prevents effectively the most common complication, a re-fracture or a pathologic fracture. Therefore we propose this surgical procedure as the treatment of choice for unicameral bone cysts in children's long bones.

Flexible intramedullary nailing in simple bone cysts of the proximal humerus

“…Excellent healing rates were reported by Roposch, [6] Givon, [7] Masquijo, [8], and Glanzmann [9]. Since then, these authors have achieved higher complete healing rates (89%), and this radiologic result of the treatment was shown 8.7 months after surgery.…”

“…The main goal of treatment is thus the prevention of pathologic fractures, support of the healing process, and prevention of recurrence. Recent studies have reported excellent results with flexible nailing [5][6][7][8][9]; therefore, we designed a prospective study to examine the efficacy of flexible intramedullary nailing for the prevention of pathologic fracture, stabilization of SBC, and promotion of lesion healing. Although earlier wide resections with or without bone grafts were performed, current concepts are based on less invasive and aggressive treatment strategies [4].…”

Surgical treatment of traumatic pediatric humeral diaphyseal fractures with titanium elastic nails

“…While there are a handful of adult case series reporting excellent healing with Enders nails [13,14], there are no dedicated reports in the pediatric literature describing the results of this technique and its complications [10][11][12]. Several small case series have shown the efficacy of this implant in treating pathologic humeral shaft fractures in children and, in particular,in promoting healing in unicameral bone cysts [15][16][17]. The aim of this report is to describe the technique and results of operative stabilization of pediatric humeral shaft fractures with titanium elastic nails.…”

A treatment strategy for proximal femoral benign bone lesions in children and recommended surgical procedures: retrospective analysis of 62 patients

“…By providing a continuous drainage between the medullary canal and the cyst cavity, elastic nails can reduce intracystic pressure and stimulate healing [26][27][28]. Elastic nails can also stabilize the pathological fractures [12,[29][30][31][32]. However, healing with a residual cyst is a frequent finding following isolated use of intramedullary nailing [33][34][35][36].…”