Flexible intramedullary nailing in simple bone cysts of the proximal humerus

Abstract

Therapeutic Level IV.

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].…”

Does Fracture Affect the Healing Time or Frequency of Recurrence in a Simple Bone Cyst of the Proximal Femur?

“…We excluded patients with the following characteristics: (1) modified cyst index [4] less than 3.5, (2) healing process underway after pathologic fracture during nonoperative treatment of a simple bone cyst, (3) recurrence after healing of a simple bone cyst treated nonoperatively or by any other treatment options, and (4) inconsistent diagnosis between the radiologist and oncologist necessitating biopsy or MRI.…”

“…The inclusion criteria were patients (1) diagnosed with simple bone cysts by an orthopaedic oncologist and a radiologist, (2) with cysts having a modified cyst index (described below) greater than 3.5 [4], (3) undergoing treatment without bone grafting or steroid injection, (4) for whom complete medical records and radiographic data were available, (5) with skeletal immaturity, and (6) who had complete records at a minimum of 8 years.…”

“…We used the modified cyst index [4] to evaluate the cyst area. This is a newly developed method of determining the cyst index based on picture archiving and communication system (PACS) software (m-view 5.4; Marosis Technologies Inc, Seoul, Korea).…”

“…However, healing time and frequency of recurrence after treatment of these cysts have not been specified as clearly or sufficiently as for cysts of the proximal humerus. Numerous studies have been performed on humeral cysts [4,7,11,19,24,25], whereas only a few have focused on femoral cysts [3,13,16,20]. Several aspects, including weightbearing, the presence of a final deformity at the end of growth, limb length, and normal gait, should be considered for femoral cysts.…”