Hotim O.A.1, Anosov V.S.1, Sychevskii L.Z.2
Comparative analysis of the results of surgical treatment for bone cysts in children
1Grodno State Medical University, Grodno, Republic of Belarus
2Grodno Regional Pediatric Clinical Hospital, Grodno, Republic of Belarus
Vestnik VGMU. 2021;20(1):55-61.
There are a number of methods for bone cysts treatment: both minimally invasive (puncture, injections) and traumatic ones with resection of the pathological area. Every method, however, has its own disadvantages and certain percentage of insufficient results. Due to this fact in Grodno Regional Pediatric Clinical Hospital and at the Chair of Traumatology, Orthopedics & Military Surgery of Grodno State Medical University we have developed a new minimally invasive combined plastic method for treating bone cysts in children.
Objectives. To make a comparative analysis of the operative treatment results of patients with bone cysts.
Material and methods. We examined the data from medical histories of 34 patients with bone cysts who were operated in Grodno Regional Pediatric Clinical Hospital in the period from 2015 to 2020. We estimated remote results of operative treatment in 24 out of 34 patients who came for medical examination.
Results. We made a comparative analysis of the operative treatment results of patients with bone cysts on the basis of which we can conclude that combined plastic method for treating bone cysts in children is the most effective one among other minimally invasive, minimally traumatic methods for treatment of such pathology in children. Positive results were obtained in 89% of patients who were operated using it. This positive effect is achieved by destruction of the inner shell with the use of laser radiation as well as cavity filling with crushed allogenic bone mixed with autogenous bone marrow. Allogenic bone is osteoconductor and its crushing leads to acceleration of regenerative process in bone tissue and prevents complications which are specific for whole bone grafts. Autogenous bone marrow is osteoinductor.
Key words: bone cyst, method of treatment, combined plasty.
1. Canale ST, Beaty JH; Daugherty K, ed. Campbell`s operative orthopedics. 12th ed. Philadelphia: Elsevier Mosby; 2013. 4637 p.
2. Weinstein SL, Flynn JM. Lovell and Winter`s pediatric orthopedics. 7th ed. Philadelphia: Lippincolt Williams and Wilkins: Wolters Kluwer business; 2014. 2544 p.
3. Verdiev FV. Bone cysts in children and adolescents (literature review). Ortopediia Travmatologiia Protezirovanie. 2014;(2):135-40. (In Russ.)
4. Herring JA, ed. Tachdjian`s Pediatric Orthopaedics: From the Texas Scottish Rite Hospital for Children. 5th ed. Philadelphia: Elsevier Saunders; 2014. 1696 p.
5. Urakawa H, Tsukushi S, Hosono K, Sugiura H, Yamada K, Yamada Y, et al. Clinical factors affecting pathological fracture and healing of unicameral bone cysts. BMC Musculoskelet Disord. 2014 May;15:159. doi: http://dx.doi.org/10.1186/1471-2474-15-159
6. Cha SM, Shin HD, Kim KC, Park JW. Does fracture affect the healing time or frequency of recurrence in a simple bone cyst of the proximal femur? Clin Orthop Relat Res. 2014 Oct;472(10):3166-76. doi: http://dx.doi.org/10.1007/s11999-014-3768-6
7. Ulici A, Nahoi C, Carp M, Fodor I, Dinu C. Surgical treatment of an aneurismal bone cyst with avascular bone graft. Chirurgia (Bucur). 2017 Mar-Apr;112(2):172-177. doi: http://dx.doi.org/10.21614/chirurgia.112.2.172
8. Erol B, Onay T, Çalışkan E, Aydemir AN, Topkar OM. Treatment of pathological fractures due to simple bone cysts by extended curettage grafting and intramedullary decompression. Acta Orthop Traumatol Turc. 2015;49(3):288-96. doi: http://dx.doi.org/10.3944/AOTT.2015.14.0108
9. Traub F, Eberhardt O, Fernandez FF, Wirth T. Solitary bone cyst: a comparison of treatment options with special reference to their long-term outcome. BMC Musculoskelet Disord. 2016 Apr;17:162. doi: http://dx.doi.org/10.1186/s12891-016-1012-0
10. Çelik S, Uludağ A, Tosun HB, Serbest S, Gürger M, Kılıç S. Unicameral (simple) and aneurismal bone cysts: the effect of insufficient curettage on recurrence. Pan Afr Med J. 2016 Aug;24:311. doi: http://dx.doi.org/10.11604/pamj.2016.24.311.9624
11. Demichev NP, Tarasov AN. Diagnostics and cryosurgery of bone cysts. Moscow, RF: MEDpres-inform; 2005. 144 р. (In Russ.)
12. Li W, Xu R, Du M, Chen H. Comparison of titanium elastic intramedullary nailing versus injection of bone marrow in treatment of simple bone cysts in children: a retrospective study. BMC Musculoskelet Disord. 2016 Aug;17(1):343. doi: http://dx.doi.org/10.1186/s12891-016-1184-7
13. Flont P, Kolacinska-Flont M, Niedzielski K. Factors predictive of positive response to steroid therapy in simple bone cysts: an old trick that still works. Int Orthop. 2013 Aug;37(8):1519-25. doi: http://dx.doi.org/10.1007/s00264-013-1912-7
14. Lee SY, Chung CY, Lee KM, Sung KH, Won SH, Choi IH, et al. Determining the best treatment for simple bone cyst: a decision analysis. Clin Orthop Surg. 2014 Mar;6(1):62-71. doi: http://dx.doi.org/10.4055/cios.2014.6.1.62
15. Spodar DV. Method for surgical treatment of dystrophic bone cysts in children: pat 2002127572 Ros Federatsiia: MPK A61B17/56, A61B18/20. № S1/02217088; zaiavl 14.10.02; opubl 10.04.04. (In Russ.)
16. Khotim OA, Anosov VS, Sychevskii LZ. Combined method of surgical treatment of bone cysts using high-intensity laser radiation and bone grafting: instruktsiia po primeneniiu № 112-1018: utv M-vom zdravookhraneniia Resp Belarus' 30.11.18 g. Grodno, RB: GrGMU, 2018. 9 р. (In Russ.)
17. Khotim OA, Anosov VS, Sychevskii LZ, Avdeichik PA, Glutkin AV. Method of combined plastics of bone cysts in children: pat 23028 BY: MPK A 61 B 17/56, A 61 B 18/20 (2006.01). № a 20180048; zaiavl 12.02.18; opubl 30.06.20, Afіts biul № 3. 4 р. (In Russ.)
Information about authors:
Hotim O.A. – lecturer of the Chair of Traumatology, Orthopedics & Military Surgery, Grodno State Medical University;
Anosov V.S. – Candidate of Medical Sciences, associate professor, pro-rector for academic affairs, Grodno State Medical University;
Sychevskii L.Z. – Candidate of Medical Sciences, head of the traumatologic and orthopedic department, Grodno Regional Pediatric Clinical Hospital.