Subperiosteal Resection of the Distal Portion of the Fibula for Aneurysmal Bone Cyst

Shoji, Hiroto; Koshino, Tomihisa; Marcove, Ralph C.; Thompson, T. Campbell

doi:10.2106/00004623-197052070-00026

Cited by 25 publications

(20 citation statements)

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“…Subperiosteal resection was proposed by Shaji et al [20] for two adolescents with large ABCs of the distal fibula in an attempt to preserve attachments of the lateral ligaments to the periosteal sleeve maintaining lateral ankle stability. 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.…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

Subperiosteal resection of fibular aneurysmal bone cyst

Mostafa

2014

Eur J Orthop Surg Traumatol

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“…7,11 Recurrence of distal fibular lesions after curettage and bone grafting have been reported for which only resection was successful. [8][9][10] Conversely, no recurrence after resection at this location has been described in the literature or in the three cases which we reported. An increased morbidity, however, must be considered.…”

Section: Discussionmentioning

confidence: 75%

“…6,14,21,26 For juxtaphyseal locations, especially in the case of large lesions, physeal damage may be inflicted by attempts at thorough curettage. 8,9 When curettage and bone grafting have been performed with care taken to preserve the growth plate 3 there have been no cases of major iatrogenic physeal disturbance, 3,4 despite the low rate of recurrence reported (20%). 3 Cases of juxtaphyseal lesions in the distal fibula successfully treated in this way were reported by Rizzo et al 3 with only minor complications and no deformity or recurrence.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5] The treatment of choice for aneurysmal bone cysts of the distal fibula has been curettage with bone grafting. Resection of the cysts, which has a lower rate of recurrence compared with curettage, 6,7 has been reported in only a few cases 2,3,6,[8][9][10][11][12][13] for such lesions in children, and different techniques of reconstruction have been performed.…”

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confidence: 99%

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Aneurysmal bone cysts of the distal fibula in children

Lampasi

Magnani

Donzelli

2007

The Journal of Bone and Joint Surgery. British volume

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We report the results of the treatment of nine children with an aneurysmal bone cyst of the distal fibula (seven cysts were juxtaphyseal, and two metaphyseal). The mean age of the children was 10 years and 3 months (7 years and 4 months to 12 years and 9 months). All had open physes. All cysts were active and in seven cases substituted and expanded the entire width of the bone (type-2 lesions). The mean longitudinal extension was 5.7 cm (3 to 10). The presenting symptoms were pain, swelling and pathological fracture. Moderate fibular shortening was evident in one patient. In six patients curettage was performed, using phenol as adjuvant in three. Three with juxtaphyseal lesions underwent resection. A graft from the contralateral fibula (one case) and allografts (two cases) were positioned at the edge of the physis for reconstruction. The mean follow-up was 11.6 years (3.1 to 27.5). There was no recurrence. At the final follow-up there was no significant difference in the American Orthopaedic Foot and Ankle Society scores (excellent/good in all cases) and in growth disturbance, alignment, stability and bone reconstitution, but in the resection group the number of operations, including removal of hardware, complications (two minor) and time of immobilisation/orthosis, were increased. Movement of the ankle was restricted in one patient. The potential risks in the management of these lesions include recurrence, physeal injury, instability of the ankle and hardware and graft complications. Although resection is effective it should be reserved for aggressive or recurrent juxtaphyseal lesions.

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“…Such instability may predispose a patient to development of arthrosis in the ankle joint. In some cases, distal fibulectomy without reconstruction has shown in good results, 12,20 however, progressive ankle valgus deformity, instability, and degenerative changes have been reported. 12 Several reconstructive options have been reported after fibulectomy.…”

Section: Discussionmentioning

confidence: 99%

Adamantinoma Arising in the Distal End of the Fibula

et al. 2016

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Adamantinoma is a rare, low-grade, malignant bone tumor. It frequently occurs in the tibia but rarely arise in the distal end of the fibula. This study reported a case of adamantinoma arising in the distal end of the fibula, resulting in good prognosis. A 38-year old female felt left ankle pain, and was suspected as having a bone tumor at the distal end of the fibula by X-ray. She was diagnosed as the classical adamantinoma of the fibula by open biopsy. En bloc wide resection of the tumor, primary arthrodesis of the ankle was performed. During the follow-up period of 7 years after the surgery, she has lived without any metastasis and local recurrence. A wide resection and arthrodesis of the ankle joint can provide a good outcome for adamantinoma arising in the end of the fibula.

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Subperiosteal Resection of the Distal Portion of the Fibula for Aneurysmal Bone Cyst

Cited by 25 publications

References 0 publications

Subperiosteal resection of fibular aneurysmal bone cyst

Subperiosteal resection of fibular aneurysmal bone cyst

Aneurysmal bone cysts of the distal fibula in children

Adamantinoma Arising in the Distal End of the Fibula

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