Aneurysmal bone cyst: the role of fibular graft in its treatment

ABSTRACT

Aneurysmal bone cyst is a relatively uncommon benign bone lesion for which curettage and cancellous bone grafting is a widely accepted method of treatment. This paper presents a report of eight patients with aneurysmal bone cysts; four in the humerus, three in the femur and one in the proximal phalanx of the index finger. Seven patients were treated by curettage and cancellous bone graft and one by autogenous fibular graft combined with cancellous allograft. Patients treated by cancellous bone grafting developed recurrence within a year. Three of these recurrent cysts were then treated by autogenous fibular graft combined with allograft. All four patients treated by fibular graft showed satisfactory healing of the cyst with no recurrence at three years' follow-up. Analysis of these patients suggests that recurrence of the aneurysmal bone cyst is very frequent after curettage and cancellous bone grafting. It is recommended that where total excision of the cyst is not feasible, the treatment of choice should be curettage and autogenous fibular bone grafting combined with cancellous bone graft. Removal of the fibula from its middle third does not cause any disability and the fibula regenerates completely within a period of three months