Efficiency of treatment methods for bone cysts of the humerus in pediatric patients

Abstract

Introduction Aneurysmal and unicameral bone cysts (abc and ubc) are non-cancerous bone Tumours. 75% occurs in fi rst two decades of life. Mostly discovered after pathological Fracture. Abc:ubc=1:1 (~0.3/100,000). Treatment is controversial. Life quality after surgery Mostly is decreased. Non-vascularized fi bula allograft can be used for restoration of the Humerus after wide cyst resection, healed 4-6 months. Objective To compare: effi ciency of the diff erent treatment methods for bone cysts of the Humerus in pediatric patients; bone structure of the humerus of the same patients’ healthy And surgically treated hand by clinical, x-ray and mri fi ndings. Material and methods: Single centre retrospective study. 34 patients with abc or ubc, from year 2000-2014. Mean Age -10.24 (± 0.54) yrs. Mean follow-up - 7.56 years (sd 4.75). 13 patients’ clinical exam., X-rays, mri were performed. Results In 31 (91.2%) patients, a cyst was diagnosed after the pathological fracture (p<0.001). 5 (45.45%) of the patients who suff ered from two or more fractures needed second surgery (p=0.002). Total reoperation rate was 18.52 % (n=27). 16 (47.06 %) abc’s and 18 ubc’s (52.94 %) were diagnosed. 14 (35 %) radical and 18 (45 %) non-radical surgeries were Performed. Average length of radical and non-radical surgeries (2h 53 min vs 1h 41 min) And postoperative stay (12 vs 8 days) was signifi cantly diff erent (p<0.05). Conclusions In 5 out of 7 patients MRIs after reconstruction of humerus using non-vascularized fi bular allograft showed no diff erence comparing to healthy humerus. After both types of surgeries patients were satisfi ed with the function of their arm and health.