Locking plate and fibular strut-graft augmentation in the reconstruction of unicameral bone cyst of proximal femur in the paediatric population

Jamshidi, Khodamorad; Mirkazemi, Masoud; Izanloo, Azra; Mirzaei, Alireza

doi:10.1007/s00264-017-3648-2

Cited by 29 publications

(30 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The average age of onset is 8 to 14 years old. [1–5] Simple bone cysts mostly occur in males, and the male-to-female ratio is 2:1 to 4:1 [1–3,6,7] ; pain caused by intercurrent pathological fracture is often the first symptom, and 63% to 87% [1,3] of cysts are combined with pathological fracture before surgery. According to the Neer evaluation criterion, bone cysts can be divided into a latent stage and an active stage, in which the active stage accounts for 37.9% to 57.9%.…”

Section: Introductionmentioning

confidence: 99%

Comparison of curettage and bone grafting combined with elastic intramedullary nailing vs curettage and bone grafting in the treatment of long bone cysts in children

2019

View full text Add to dashboard Cite

To compare the efficacy of curettage and bone grafting combined with elastic intramedullary nailing (EIN) vs curettage and bone grafting in the treatment of long bone cysts in children and to clarify the necessity of using EIN in the treatment of bone cysts. Sixty-two patients were involved in this study from Jan. 2009 to Sept. 2017 (43 males, 19 females; 27 humeri, 35 femurs); the patients were assigned to an EIN group, comprising 30 patients who underwent curettage and bone grafting combined with EIN, or to a non–elastic intramedullary nailing (NEIN) group, comprising 32 patients who underwent curettage and bone grafting alone. The prognosis of the 2 groups was assessed with reference to the standard of Capanna. No statistically significant differences in sex, age, location, activity, pathological fracture, cyst volume, operative time and intraoperative blood loss were found between the 2 groups ( P > .05). The effective rate was 90.0% in the EIN group and 68.8% in the NEIN group, and the difference was statistically significant ( P < .05). Compared to simple curettage and bone grafting, curettage and bone grafting combined with EIN treatment can significantly improve the prognosis of children with bone cysts. It is recommended that EIN be added to bone cyst curettage and bone grafting.

show abstract

Section: Introductionmentioning

confidence: 99%

Comparison of curettage and bone grafting combined with elastic intramedullary nailing vs curettage and bone grafting in the treatment of long bone cysts in children

2019

View full text Add to dashboard Cite

show abstract

“…Reports on the use of the LCP® Proximal Femoral Plate (Synthes, Inc.) in musculoskeletal oncology reconstruction are limited [11][12][13]23 [24,25]. However, these failures occurred in patients with mechanical collapse due to varus deformity with inadequate posteromedial support of severely comminuted fractures.…”

Section: Discussionmentioning

confidence: 99%

“…However, serious complications, including pulmonary embolism, have been reported in patients treated with intramedullary nailing with or without reaming [9,10]. Proximal femoral locking plate xation is an alternative implant for impending or pathological fracture in benign or metastatic bone tumours that can reduce the incidence of pulmonary embolism in pathological fractures of the proximal femur [11][12][13]. Wide excision of tumour with prosthetic reconstruction is a treatment option for patients with hypervascularized metastatic bone disease; however, increased blood loss is often observed during intralesional curettage.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of proximal femoral locking-plate fixation for pathological fractures of the proximal femur

Riansuwan

Jivasomboonkul

Phimolsarnti

et al. 2020

Preprint

View full text Add to dashboard Cite

Background Intramedullary nailing of long bones is a common technique for management of existing or impending pathological fracture of the proximal femur. This fixation has been shown to be biomechanically superior to the locking-plate system. However, serious complications, including pulmonary embolism, have been reported in patients treated with intramedullary nailing with or without reaming. The purpose of this report was to study the treatment outcomes of proximal femoral locking-plate fixation of pathological fractures of the proximal femur relative to clinical results, implant failure, and surgical complications. Methods From 2007 to 2018, 17 patients (18 femurs) with a diagnosis of impending or existing pathological fracture of the proximal femur were treated with proximal femoral locking-plate fixation. Data collected included operative duration, estimated blood loss, ambulatory status, hardware failure events, and postoperative complications. Results Of the 18 femurs that were included, 13 were existing pathological fractures and 5 were impending fractures. The mean age of patients was 53.7 years (range: 28–89), and 12 of them were female. The mean follow-up was 11.3 months (range: 1–67). Ten of 17 patients (62.5%) had progressive lung disease from pulmonary metastasis or from lung primary. No patient developed oxygen desaturation or cardiac arrest during the intraoperative or postoperative period. Thirteen of 17 patients (76.5%) could walk with or without an assistive device at the time of final follow-up. Two patients required close postoperative monitoring in the ICU due to poor preoperative status, and both of those patients died within one month after surgery from other medical problems. No hardware failure occurred. Conclusion For pathological fracture of the proximal femur, proximal femoral locking-plate fixation is a treatment option that results in fewer perioperative and postoperative cardiopulmonary events and surgical complications. Most patients can ambulate with or without an assistive device at the final follow-up.

show abstract

“…The current study evaluated the outcome of a new method to manage UBC types IB and IIB of proximal femur in pediatric population using locking plate and fibular strut-graft augmentation (3). In this method, it was assumed that when the fixation is extended to the femoral shaft, a locking plate could act like a lateral buttress, while its implementation along with fibular strut graft could potentially decrease the risk of fracture, graft resorption, and screw cut-out.…”

Section: Dear Editormentioning

confidence: 99%

“…In this method, it was assumed that when the fixation is extended to the femoral shaft, a locking plate could act like a lateral buttress, while its implementation along with fibular strut graft could potentially decrease the risk of fracture, graft resorption, and screw cut-out. In addition, this procedure obviates the need for a plaster cast and allows an early return of the patient to normal activity (3).…”

Section: Dear Editormentioning

confidence: 99%

Management of Unicameral Bone Cyst of Proximal Femur in Pediatric Population

Jamshidi

Mirzaei

2018

Shafa Ortho J

Self Cite

View full text Add to dashboard Cite

Unicameral bone cyst (UBC) is a benign lesion that mostly affects children in the age range of 4-10 years, and proximal femur is considered as the second most common anatomical location of the lesion. While an asymptomatic cyst with sufficient cortex in the upper extremities only needs observation, a lesion in the proximal femur requires surgical intervention.Several different interventional strategies including radical excision, subtotal resection with and without bone graft, curettage and bone graft, multiple drill holes, intracystic prednisolone injection, and intra-medullary flexible nails are applied to treat UBC. However, evidence is not enough to support the superiority of one treatment over another and the optimal treatment of UBC remains a challenge. The risks of recurrence and fixation failure are noted as major drawbacks of conventional interventions (1).Management of UBC of proximal femur in pediatric population is even more challenging, especially in types IB and IIB of classification introduced by Dormans and Pill. This classification is developed to guide the treatment of lytic lesions of the proximal femur with respect to the location and size of the cyst. In type I of the Dormans classification, the cyst does not involve the femoral neck, while in type II the cyst is located in the femoral neck. Moreover, subdivision B refers to the cysts where sufficient bone stock is not available on the lateral side of the proximal femur (2). In the Dormans types IB and IIB, with insufficient bone stock in lateral buttress, the fracture risk is higher. Consequently, the management of the cyst requires careful considerations. However, the selected device should not damage the trochanteric apophysis and epiphyseal plate of proximal femur.The current study evaluated the outcome of a new method to manage UBC types IB and IIB of proximal femur in pediatric population using locking plate and fibular strut-graft augmentation (3). In this method, it was assumed that when the fixation is extended to the femoral shaft, a locking plate could act like a lateral buttress, while its implementation along with fibular strut graft could potentially decrease the risk of fracture, graft resorption, and screw cut-out. In addition, this procedure obviates the need for a plaster cast and allows an early return of the patient to normal activity (3).At a mean follow-up period of 41.7 months, no recurrence, fracture and screw cut-out were observed in this series after the application of this method and none of the cases of the current study needed a re-operation (3).Based on the obtained results, authors believe that the employed strategy to manage pediatric UBC types of IB and IIB of proximal femur using locking plate and fibular strut graft augmentation could be regarded as an acceptable surgical intervention associated with a favorable outcome and early mobilization. Thus, it has the potential to be introduced as the most reliable method to manage such lesions. References

show abstract

Locking plate and fibular strut-graft augmentation in the reconstruction of unicameral bone cyst of proximal femur in the paediatric population

Abstract: According to our results, locking plate and fibular strut graft in Dormans classification types IB and IIB results in a favorable outcome in managing UBC of the proximal femur in the paediatric population.

Cited by 29 publications

References 30 publications

Comparison of curettage and bone grafting combined with elastic intramedullary nailing vs curettage and bone grafting in the treatment of long bone cysts in children

Comparison of curettage and bone grafting combined with elastic intramedullary nailing vs curettage and bone grafting in the treatment of long bone cysts in children

Outcomes of proximal femoral locking-plate fixation for pathological fractures of the proximal femur

Management of Unicameral Bone Cyst of Proximal Femur in Pediatric Population

Contact Info

Product

Resources

About