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Background: Simple bone cysts are benign bony lesions. Treatment strategies are varied for this particular pathology. It remains controversial as to what the ideal treatment strategy is. Recently, bony substitute injections have emerged as a potential option for treatment. This paper aimed to describe our institution's experience in using bony substitute injections to treat unicameral bone cysts. Methods: A retrospective review of consecutive patients over an 84-month period at a tertiary paediatric hospital was performed. Information regarding patients' presentation, diagnosis, and management was recorded and summarised. Results: A total of 15 patients were included in our study, with a mean follow-up of 118 weeks. 86.7% of patients demonstrated clinical resolution (absence of pain at the latest follow-up) and 80% of patients demonstrated radiographic resolution. Only one patient sustained a subtrochanteric fracture post-index operation, whilst two others demonstrated redevelopment of cystic architecture on follow-up. Conclusion: This study demonstrates that bone substitute injection is potentially a minimally invasive and seemingly successful technique in the treatment of unicameral bone cysts and other simple bone lesions. Further randomised and comparative studies are required to confirm and validate our findings.
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INTRODUCTION: We noticed that fewer patients with self-poisoning were transferred from the ED to the Intensive Care Unit (ICU) than previously. To objectify this, we evaluated ED and ICU admissions in two time periods. METHODS: The number of admissions was collected during 1994-1998 and 2010-2014. As a sample survey, full records of patients with an intoxication from January 2010 till December 2010 were studied. RESULTS: From 2010-2014 26 patients/year were admitted from the ED to the ICU; from 1994-1998 51 patients/year (p=0.0001). In 2010, 270 patients presented to our ED; 31 were admitted to the ICU; 1 patient died. Time spent in the ED was 236 min for patients who went home, 290 min for patients who went to a nursing ward and 185 minutes for patients transferred to the ICU. CONCLUSION: We found indeed fewer ICU admissions in recent years. Changing work routines - a longer observation period in the ED, causing a workload shift from the ICU to the ED, more than changing patient or drug characteristics, may be the cause for this development.
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OBJECTIVE: The main object of this study was to use a geometric morphometric approach to quantify the left-right symmetry of talus bones. METHODS: Analysis was carried out using CT scan images of 11 pairs of intact tali. Two important geometric parameters, volume and surface area, were quantified for left and right talus bones. The geometric shape variations between the right and left talus bones were also measured using deviation analysis. Furthermore, location of asymmetry in the geometric shapes were identified. RESULTS: Numerical results showed that talus bones are bilaterally symmetrical in nature, and the difference between the surface area of the left and right talus bones was less than 7.5%. Similarly, the difference in the volume of both bones was less than 7.5%. Results of the three-dimensional (3D) deviation analyses demonstrated the mean deviation between left and right talus bones were in the range of -0.74 mm to 0.62 mm. It was observed that in eight of 11 subjects, the deviation in symmetry occurred in regions that are clinically less important during talus surgery. CONCLUSIONS: We conclude that left and right talus bones of intact human ankle joints show a strong degree of symmetry. The results of this study may have significance with respect to talus surgery, and in investigating traumatic talus injury where the geometric shape of the contralateral talus can be used as control. Cite this article: Bone Joint Res 2014;3:139-45.
