Subperiosteal resection of aneurysmal bone cysts of the distal fibula

Abu-Hassan, Freih; Shannak, Akram

doi:10.1302/0301-620x.91b9.22395

Cited by 17 publications

(25 citation statements)

References 27 publications

(54 reference statements)

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“…Failure of healing of the bone defect was noted in one patient and was explained by the use of suction drain, which evacuated the tube hematoma and allowed the periosteal walls to get adherent to each other. Abuhassan and Shannak [21] reported one patient with delayed incorporation of the regenerated bone at the proximal end of subperiosteal resection of distal fibular ABC after an electric saw had been used to cut the bone. The mean healing time of the bone defect in the present series 6.4 months (4-10 months) was comparable with that after intralesional curettage and bone graft 11.6 months (8-15 months) and after injection with steroids or bone marrow 13.9 months (15-18 months)).…”

Section: Discussionmentioning

confidence: 99%

“…The technique was modified and adopted by Abuhassan and Shannak [21] highlighting the value of the preserved periosteum in regenerating a new bone avoiding the morbidity with other techniques. The current study was conducted to evaluate the results of subperiosteal resection of ABCs of the fibula and its efficiency in eradicating the disease, preventing local recurrence and maintaining function.…”

Section: Introductionmentioning

confidence: 99%

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Subperiosteal resection of fibular aneurysmal bone cyst

Mostafa

2014

Eur J Orthop Surg Traumatol

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Aneurysmal bone cyst (ABC) of the fibula poses a challenge as to the most appropriate treatment particularly in children and adolescents. A prospective study was conducted to evaluate the results of subperiosteal resection of fibular ABCs. Eleven patients (six boys and five girls) with an average age of 12.4 years (6-18 years) were treated by subperiosteal resection of ABC of the fibula. The lesion was juxtaphyseal in three patients (two distal and one proximal), metaphyseal in seven and diaphyseal in one. All cysts were active and centrally located type 2. The modified Enneking scoring system was used for final functional evaluation while a scale proposed by the author was used for final radiological assessment. At the final follow-up, there was no difference in the range of movement, alignment or stability of the ankle or the knee when compared with the opposite side. Three patients complained of mild discomfort on heavy activity. One patient had failure of healing that was related to the use of suction drain. After a mean follow-up of 41.6 months (24-64 months), the mean functional score was 98.8% (93-100%). According to the proposed radiological scale, six patients were rated excellent, three good, one fair and one poor. In conclusion, subperiosteal resection is effective in eradicating fibular ABCs, regenerates a new bone and avoids the morbidity of other techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Subperiosteal resection of fibular aneurysmal bone cyst

Mostafa

2014

Eur J Orthop Surg Traumatol

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“…La eliminación del tercio medio de peroné no causa ninguna discapacidad y el peroné se regenera completamente en un plazo de tres meses. Abuhassan y cols., 25 en una serie de ocho pacientes (7 con placa de crecimiento abierta), muestran el papel del periostio en la regeneración del defecto óseo generado; el tamaño medio de la pieza resecada fue de 5,12 cm; todos tenían la regeneración completa del defecto óseo dentro de 3 a 9 meses, sin inestabilidad de la articulación, ni alteración en el rango de movilidad; la duración media del seguimiento fue de 11.5 años. El paciente de nuestra serie tratado con curetaje, aloinjerto e injerto no vascularizado de peroné tuvo una recidiva de la lesión, fue tratado con nuevo curetaje y colocación de aloinjerto, y finalmente, se logró un buen resultado.…”

Section: Discussionunclassified

Tratamiento de quistes óseos aneurismáticos con aloinjerto. [Treatment of aneurysmal bone cysts with allograft.]

Nùñez

Chelle²,

Fajardo³

et al. 2016

Rev. Asoc. Arg. Ort. y Traumatol

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ResumenAntecedentes: Los pacientes con quiste óseo aneurismático plantean dificultades diagnósticas y terapéuticas. Se han descrito múltiples opciones terapéuticas. Objetivos: Evaluar los resultados obtenidos en pacientes tratados con curetaje y relleno con aloinjerto óseo. Materiales y Métodos: Se analizaron 16 quistes, correspondientes a 15 pacientes, con un seguimiento mínimo de 28 meses y una mediana de seguimiento de 83 meses. Resultados: La media de la edad era de 10 años (rango 3-16). La principal complicación fue la recidiva (37,5%), que fue más frecuente cuando existía compromiso fisario (62,5% frente al 12,5% sin compromiso; p = 0,05). La frecuencia de recidiva no varió en ambos sexos, para las distintas edades analizadas y respecto al uso o no de fresa de alta velocidad. Conclusión: Consideramos que el tratamiento realizado es seguro, pero tiene una alta tasa de recidivas, similar a las publicadas en otras series.Palabras clave: Quiste óseo aneurismático; aloinjerto. Nivel de Evidencia: IV Treatment of aneurysmal bone cysts with allograft AbstractBackround: Patients with aneurysmal bone cyst pose diagnostic and therapeutic difficulties. Multiple therapeutic options have been described. Objective: To evaluate the results obtained in patients treated with curettage and filling with bone allograft. Methods: Sixteen cysts, corresponding to 15 patients were evaluated, with a minimum follow-up of 28 months and a median follow-up of 83 months. Results: Average age was 10 years (range 3-16). The main complication was recurrence in 37.5% of patients, being more frequent with physeal involvement (62.5% vs. 12.5% without involvement; p = 0.05). The recurrence rate was unchanged for both sexes, for different ages and regarding the use or not of high-speed burr. Conclusion: We think that the treatment performed is safe, but recurrence rate is high, similar to that reported in other series.

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“…These findings suggest that, although resection is effective, it should be reserved for aggressive or recurrent lesions [17]. In contrast, others have reported excellent functional outcomes in patients who had undergone resection for aneurysmal cysts [18] or osteochondromas of the distal fibula [22].…”

Section: Literature Reviewmentioning

confidence: 99%

Clinical management and surgical treatment of distal fibular tumours: a case series and review of the literature

Perisano

Marzetti

Spinelli

et al. 2012

International Orthopaedics (SICOT)

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Purpose Study reports clinical and functional outcomes of surgical treatment in a case series of nine patients with distal fibular tumours. Methods Nine patients with distal fibular tumours were observed between 2005 and 2010. A PubMed search was performed using the terms "fibula", "lower limb tumour [cancer]", "sarcoma", "Ewing", "peroneal", "fibular metastasis", and "limb-salvage surgery". Results In all our patients, lesions were unilateral. All patients complained of pain; limping was present in 5 of 9 tumours. Patients were managed surgically, except one who underwent local radiotherapy. In six patients, a benign or tumor-like lesion was detected. Malignancies consisted of metastatic lung adenocarcinoma (two cases) or multifocal mesenchymal cancer (one case). Non-malignant lesions were treated by curettage and filling, followed by internal fixation when needed. In malignant or locally aggressive lesions, metadiaphyseal fibular resection was performed. The literature search retrieved either case reports or small case series, reflecting the rarity of distal fibular tumours. Surgical treatment was successful in all patients with benign lesions, whereas the rate of success was 40-100 % in case of malignancies. Conclusions Given the low incidence of distal fibular tumours, controversies exist about the optimal surgical management. Clinical observation and imaging should be reserved to asymptomatic benign lesions. In non-malignant tumours causing pain, limping, and pathological fractures; in malignancies, surgery is recommended. Finally, in patients with asymptomatic lesions of uncertain nature, biopsy and histological examination should be performed to plan appropriate management.

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Subperiosteal resection of aneurysmal bone cysts of the distal fibula

Cited by 17 publications

References 27 publications

Subperiosteal resection of fibular aneurysmal bone cyst

Subperiosteal resection of fibular aneurysmal bone cyst

Tratamiento de quistes óseos aneurismáticos con aloinjerto. [Treatment of aneurysmal bone cysts with allograft.]

Clinical management and surgical treatment of distal fibular tumours: a case series and review of the literature

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