Intramedullary Decompression for the Treatment of Unicameral Bone Cysts in Children / 대한정형외과학회잡지

ABSTRACT

PURPOSE: The present study aims at evaluating our results of intramedullary decompression of the unicameral bone cysts in children with using flexible nail(s) or titanium cannulated screws. MATERIALS AND METHODS: We treated fourteen children with unicameral bone cysts by intramedullary decompression. Eleven cases were in the metaphysis of long bones (seven in the proximal humerus amd four were in the proximal femur), which were all treated by flexible intramedullary nailing; while a cancellous screw was axially placed in three cysts of the short bones (all in the calcaneus). The mean age of the patients at the time of surgery was 11.8 years, and the mean duration of follow-up was 16.7 months. The final outcome was radiographically classified into the four categories of Capanna et al.,; completely healed, healed with residual radiolucency, recurred or having no response. RESULTS: All of the cysts In the long bones responded to treatment. Seven cysts healed completely, and three healed with residual radiolucent areas visible on radiographs. One cyst, which initially appeared completely healed, recurred after the removal of nails. The healing period varied from three to 36 months. For the calcaneal cysts, there was no definite sign of effective consolidation in all three cases. CONCLUSION: Intramedullary decompression by flexible nailing for the treatment of unicameral bone cyst of a long bone was effective in providing early stability and for accelerating consolidation of the cyst. Its surgical intervention is minimal, and the result is predictable. Our trial of placing a screw in the calcaneal cysts was unsuccessful according to the short term follow-up.