Die juvenile Knochenzyste - Behandlungsvorschläge und neue Ergebnisse

Abstract

The simple bone cyst (sbc) is generally regarded as a tumourous bone lesion, to be classified with the bone tumours. It is a non-malignant disease which, however, affects adolescents in the immediate area of the epiphysis, so that disturbances of growth and deformities cannot always be avoided. The commonest localisation is stated to be at the proximal humerus, followed by the femur. The authors shell out small sbc, filling the defect with autologous spongiosa, but treat recurrences and extensive cyst formation by means of limb-preserving resection. Procedure followed, e.g. at the humerus; resection of the tumour en bloc, formation of a groove in the head of the humerus, into which an autologous tibia graft is driven, after this has been fitted into the distal humerus after Lexer, where the transplant is fixed by 2 AO screws, or by boring the graft into the marrow canal of the distal humerus, without using extraneous material for osteosynthesis. Postoperative stabilisation is effected in a thoracic abduction plaster for an average of about 12 weeks. A review of the results of treatment in 26 patients with sbc of the humerus showed a recurrence rate of 55% after curettage and filling with spongiosa, against 7% following resection. Complete removal of the cyst by resection can thus be taken to be the most reliable prophylaxis against recurrence in the upper arm. In certain cases, we also perform a subtotal resection of the proximal femur. Of these patients, 22 were followed up:(ABSTRACT TRUNCATED AT 250 WORDS)

Elastic Stable Intramedullary Nailing for the Treatment of Complicated Juvenile Bone Cysts of the Humerus

“…± Curettage of the JBC with subsequent refilling can be accomplished by filling materials such as autogenous cancellous bone (16,20), allogene cortical bones (20), tricalciumphosphate-ceramics (1) or hydroxyapatite (8). This does not stabilise the fracture, and this type of operation is theoretically suitable only for large, uncomplicated and accidentally discovered JBCs.…”