Triple methylprednisolone injections for simple humerus cysts at one-month intervals

Çakar, Murat; Bülbül, Ahmet Murat

doi:10.5222/otd.2018.34654

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…For UBCs located in asymptomatic and non-weight-bearing areas, treatments such as alendronate and botulinum toxin have been trialed but have not gained widespread acceptance [ 3 ]. Possible interventions for these patients include methylprednisolone injections, applications of autologous bone marrow, or a combination of demineralized bone matrix with bone marrow [ 4 ]. It is recognized that UBCs in the pertrochanteric region or those with significant enlargement (where the transverse diameter exceeds 85% or there is less than 0.55 mm of cyst wall remaining during follow-up) necessitate surgical treatment [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Decompression and Grafting in Acute Pathological Proximal Femur Fractures in Children with Unicameral Bone Cysts: A Retrospective Study Utilizing a 120° Fixed-Angle Low-Contact Locking Pediatric Hip Plate

Adaş,

Çakar,

Demirkale

2023

Med Sci Monit

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Background Unicameral bone cysts (UBCs) are benign tumor-like lesions that are the most common cause of pathological proximal femur fracture in children. This study aimed to present the outcomes of acute, unstable, pathological proximal femur fractures secondary to UBCs in children. Material/Methods We retrospectively reviewed data on 12 patients with a mean age of 9.3 years (7–12 years) who were initially treated with decompression and grafting, followed by stabilization using a 120° fixed-angle low-contact locking pediatric plate (LCLPP). The Musculoskeletal Tumor Society (MSTS) scores, Capanna classification of cyst repair, time to union, collodiaphyseal angle (CDA), and limb length discrepancy (LLD) were evaluated. Results The mean follow-up was 33.1 months (range, 13–96 months). The mean union time was 9.5 weeks (8–14 weeks). The mean time for reparation of the cyst was 6.9 months (range 3–9 months). Four patients had Dormans type IB, while the remaining had type IIB fractures. According to the Capanna classification, repairs in 10 cases were grade I and in 2 cases grade II. At the last follow-up, the mean 120.8° of preoperative CDA was corrected to 140.9° ( P <0.001) and there was no difference compared to the healthy side ( P =0.214). The mean postoperative MSTS score was 97.1% (29.1 points). Two patients experienced LLD at the affected extremities, while the other 10 patients healed without any complications. Conclusions Fixation of acute unstable fractures secondary to UBCs with a 120 ° fixed-angle LCLPP is a reliable and successful option after decompression and grafting of the lesion.

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Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Decompression and Grafting in Acute Pathological Proximal Femur Fractures in Children with Unicameral Bone Cysts: A Retrospective Study Utilizing a 120° Fixed-Angle Low-Contact Locking Pediatric Hip Plate

Adaş,

Çakar,

Demirkale

2023

Med Sci Monit

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“…Glasser et al reported that 66% of patients who underwent steroid injection required open surgery(25). Cakar et al(27) reported 82% improvement in proximal humerus lesions with this treatment. In our study, when we divided the patients into two groups as patients having cysts in the upper and lower extremities, we found no significant relation between the cysts in upper and lower extremities in terms of the success of this treatment.…”

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confidence: 99%

Results of the Local Steroid Injections in the Simple Bone Cyst

Uçan¹,

Pulatkan²,

Erdem³

et al. 2020

Bezmialem Science

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ÖZ ABSTRACTAmaç: Basit kemik kistinin (BKK) tedavi alternatiflerinden biri olan lezyon içine steroid uygulamasının etkinliğini araştırmaktır.Yöntemler: BKK saptanan 17 hasta (11 erkek, 6 kız ; ortalama yaş 12,4 yıl; dağılım 2-39 yıl) iki iğne tekniği kullanılarak kist içine metilprednizolon asetat (MPA) enjeksiyonuyla tedavi edildi. Kist altı olguda humerus proksimaline, iki olguda kalkaneusa (olgulardan biri bilateral), yedi olguda proksimal femura ve iki olguda da tibiaya yerleşmişti. Üç hastada steroid enjeksiyonu öncesinde patolojik kırık oluşmuştu. Patolojik kırığı olan bu üç hastaya kırıkları iyileştikten sonra MPA enjeksiyonu yapıldı. Hastalara sekiz hafta arayla, herbiri 40-160 mg MPA içeren en fazla dört enjeksiyon uygulandı. Hastalar enjeksiyon sonrasında birinci, üçüncü, altıncı aylarda ve birinci yılda çekilen direkt grafiler ile takip edildi. İlk yıldan sonra hastalar yılda bir kez düz grafilerle takibe alındı. Hastaların ortalama takip süresi 22 ay (dağılım=3-48 ay) idi. Kist iyileşmesi modifiye Neer sınıflandırmasına göre değerlendirildi.Bulgular: MPA enjeksiyonu ile 10 kistte (%55) tamamen, üç kistte (%17) rezidüel lezyonla iyileşme sağlandı. Üç kistte (%17) steroide hiç yanıt alınamadı, iki hastada lezyon tekrarladı (%11). Tamamen veya rezidüel lezyonla iyileşen hastalardaki sonuçlar tatminkar bulunurken (%72), beş hastada (%28) steroid tedavisi başarısız bulundu. Bu hastalar küretaj ve greftleme veya sementleme ile tedavi edildi. İşlemle ilgili hiçbir hastada komplikasyon görülmedi.Objective: Steroid injections represent one of the simple treatment alternatives for simple bone cysts (SBC). The aim of this study was to evaluate the results of local steroid injections in the treatment of SBC.Methods: Seventeen patients (11 males, 6 females; mean age 12.4 years; range=2 to 39 years) with SBC were treated with injection of methylprednisolone acetate (MPA) with the use of the two-needle technique. The cysts were localized in the proximal humerus (n=6), the calcaneus (one patient had bilateral lesions) (n=2), proximal femur (n=7) and the tibia (n=2). Pathological fractures occurred in three patients before steroid injection. These three patients with pathological fractures were treated with injection of MPA after fractures healed. Each patient received a maximum of four injections at eight week intervals, each consisting of 40-160 mg of MPA. The patients were followed up with plain radiographs obtained in the first month, third month, sixth month, and at the end of a year. After the first year, patients were followed up with plain radiographs once a year. The mean follow-up duration was twenty two months (range=3 to 48 months). Cyst healing was assessed according to the modified Neer classification.Results: Treatment with MPA resulted in complete recovery in ten cysts (55%) and recovery with residual lesions in three cysts (17%). Three cysts (17%) did not respond to steroid treatment and two patients (11%) developed recurrence. The results were satisfactory (72%) in patients with complete recovery and...

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Triple methylprednisolone injections for simple humerus cysts at one-month intervals

Cited by 2 publications

References 19 publications

Long-Term Outcomes of Decompression and Grafting in Acute Pathological Proximal Femur Fractures in Children with Unicameral Bone Cysts: A Retrospective Study Utilizing a 120° Fixed-Angle Low-Contact Locking Pediatric Hip Plate

Long-Term Outcomes of Decompression and Grafting in Acute Pathological Proximal Femur Fractures in Children with Unicameral Bone Cysts: A Retrospective Study Utilizing a 120° Fixed-Angle Low-Contact Locking Pediatric Hip Plate

Results of the Local Steroid Injections in the Simple Bone Cyst

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