Abstract
Unicameral bone cyst is a frequent benign lesion of the child’s skeleton of unclear ethopathology and scarce symptoms.Possible complications and limits in the child’s activities necessitate an active approach to management.
Intracystic injection of corticosteroid depot, curettage of the cyst and bone grafting and osteoinduction procedures are three frequently used therapeutic procedures.Having in mind that attitudes regarding initial treatment are still heterogeneous, in period 1992–2001, we have conducted a study aimed at making a comparative analysis of those commonly applied methods of treatment.
The prospective randomised study included 37 patients treated with corticosteroid injections, 32 patients treated with curettage and bone grafting and 31 patients treated with osteoinduction procedure.As osteoinductive material we used mixture of demineralised bone matrix powder and autologous bone marrow.
Results evaluation was based on criteria designed by Neer,Campannaci and Capanna.Mean follow up period was 6,5 years.
In our patients results of initial treatment were good, regardless of the applied method and they do not significantly differ from the results of other authors.No significant difference in treatment outcome was statistically revealed and frequency of recurrence does not vary in relation to applied method.
Mean failure rate was 18%,mean recurrence rate 10% and mean rate of usual complications 17%.
Under conditions of similar efficiacy, it is justified to apply a less invasive method in the initial treatment.
Methods of corticosteroid injection and osteoinduction are advantageous in cysts with physeal and epiphyseal propagation especially in the upper limb. Besides, those methods are characterised by simplicity, safety and short duration of intervention and hospitalisation and short limitation of the child’s activity.In exceptionally large cysts, as well as in cysts localised in the femoral neck and complicated with displaced fracture which requires reposition and osteosynthesis, the advantage is given to curetage and bone grafting.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
