Outcomes from Treatment of Simple Bone Cyst in the Long Bones with Flexible Intramedullary Nailing in Children and Adolescents: A Retrospective Cases Series

Soo-Min Cha; Hyun-Dae Shin; Kyung-Cheon Kim; Jung-Mo Hwang; Bo-Kun Kim

doi:10.4055/jkoa.2012.47.3.178

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Cha, Shin, Kim, Hwang, and Kim: Outcomes from Treatment of Simple Bone Cyst in the Long Bones with Flexible Intramedullary Nailing in Children and Adolescents: A Retrospective Cases Series

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2012; 47(3): 178-184.

Published online: 26 June 2012

DOI: https://doi.org/10.4055/jkoa.2012.47.3.178

Outcomes from Treatment of Simple Bone Cyst in the Long Bones with Flexible Intramedullary Nailing in Children and Adolescents: A Retrospective Cases Series

Soo-Min Cha, M.D., Hyun-Dae Shin, M.D., Ph.D., Kyung-Cheon Kim, M.D., Ph.D., Jung-Mo Hwang, M.D., Bo-Kun Kim, M.D.^*

Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Korea.

^*Department of Orthopedic Surgery, Dong-A University College of Medicine, Busan, Korea.

Correspondence to: Hyun-Dae Shin, M.D., Ph.D. Department of Orthopedic Surgery, Chungnam National University Hospital, Chungnam National University School of Medicine, 282, Munwha-ro, Jung-gu, Daejeon 301-721, Korea. TEL: +82-42-280-7349, FAX: +82-42-252-7098, hyunsd@cnu.ac.kr

Received 24 July 2011 Revised 26 August 2011 Accepted 29 August 2011

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

A retrospective review of cases series about the outcomes of treatment for simple bone cyst in the long bones with flexible intramedullary nailing in children and adolescents.

Materials and Methods

Eighty-five cases with a simple bone cyst in the long bones diagnosed between April 2002 and December 2007 were enrolled in the study. The mean age of the patients was 10.8 years. Thirteen cases were accompanied by a pathological fracture, and 72 cases were not. Thirty-three cases had a simple bone cyst on the proximal humerus, 41 cases on the shaft of the humerus, and 11 cases on the proximal femur. Steroid injections were performed in 21 cases (group 1), curettage and a synthetic bone graft in 18 cases (group 2), and decompression and fixation using flexible intramedullary nailing in 46 cases (group 3). We followed up all cases for at least 24 months and evaluated the results according to the Capanna classification.

Results

The mean duration for absorption and healing of bone cysts was 18.4 months in group 1, 10.6 months in group 2, and 5.8 months in group 3. The complete cure rate according to the Capanna classification was 67% in group 1, 56% in group 2, and 78% in group 3. There was one case of recurrence in group 1 (5%), one case in group 2 (6%), and one case in group 3 (2%), as well as two cases of "no response to treatment" in group 1 (9%) and one case in group 2 (6%).

Conclusion

Flexible intramedullary nailing for simple bone cysts in children and adolescents is effective for healing cystic lesions with a short healing duration and for mechanical stability.

Keywords: bone cyst, flexible intramedullary nail

Figures and Tables

Figure 1

(A) Pre-operative simple radiograph of a 12-year-old boy, who had simple bone cyst involving the metaphysis of proximal humerus, associated with pathologic fracture. (B, C) Post-operative radiographs show the inserted flexible intramedullary nails. (D) Cyst absorption and bone healing was achieved at post-operative 5 months.

Table 1

Summary of the Cases according to the Anatomical Location of the Cyst and Options for the Treatments

^*Absence of pathologic fracture; ^†Presence of pathologic fracture.

Table 2

Summary of the Outcomes of Each Group, using the Classification by Capanna

Values are presented as n (%). ^*Absence of pathologic fracture; ^†Presence of pathologic fracture.

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