Operative Orthopadie und Traumatologie · 2026
[Surgical management of juvenile and aneurysmal bone cysts in children and adolescents : Curettage, ceramic bone graft substitution and adjuvants].
СтатьяКлиническое исследованиеАннотация на английскомНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Dietz Sven-Oliver, Jung Beatrice, Nienhaus Michael, Traub Frank, Gercek Erol
Аннотация
OBJECTIVE: The aim of treating juvenile (UBC) and aneurysmal bone cysts (ABC) is complete defect filling with subsequent bony consolidation, restoration of stability, pain reduction, and minimization of recurrence risk.
INDICATIONS: Symptomatic or pathologic fractures due to confirmed UBC or ABC based on imaging and/or histology.
CONTRAINDICATIONS: Suspected malignancy based on clinical or radiologic findings.
SURGICAL TECHNIQUE: After fluoroscopic localization, the lesion is exposed via a tissue-sparing approach. The cyst wall is opened, and complete curettage is performed. The defect is filled with ceramic bone substitute and/or allogeneic cancellous bone soaked in methylprednisolone (UBC) or polidocanol (ABC). In ABC, the cyst lining is completely removed. In UBC, curettage combined with elastic-stable intramedullary nailing (ESIN) for stabilization is frequently sufficient.
POSTOPERATIVE MANAGEMENT: Fractures are managed like nonpathologic fractures. Radiographic follow-up is performed at 4, 12, 26, and 52 weeks. If ABCs fail to respond, repeated percutaneous polidocanol injections are administered.
RESULTS: In a cohort of 44 patients (22 UBC, 23 ABC), after a follow-up of up to 6 years, 82% achieved a favorable radiological outcome (Capanna 1-2). Recurrence with refracture occurred in 4 patients after ESIN removal. The overall complication rate was low.
INDICATIONS: Symptomatic or pathologic fractures due to confirmed UBC or ABC based on imaging and/or histology.
CONTRAINDICATIONS: Suspected malignancy based on clinical or radiologic findings.
SURGICAL TECHNIQUE: After fluoroscopic localization, the lesion is exposed via a tissue-sparing approach. The cyst wall is opened, and complete curettage is performed. The defect is filled with ceramic bone substitute and/or allogeneic cancellous bone soaked in methylprednisolone (UBC) or polidocanol (ABC). In ABC, the cyst lining is completely removed. In UBC, curettage combined with elastic-stable intramedullary nailing (ESIN) for stabilization is frequently sufficient.
POSTOPERATIVE MANAGEMENT: Fractures are managed like nonpathologic fractures. Radiographic follow-up is performed at 4, 12, 26, and 52 weeks. If ABCs fail to respond, repeated percutaneous polidocanol injections are administered.
RESULTS: In a cohort of 44 patients (22 UBC, 23 ABC), after a follow-up of up to 6 years, 82% achieved a favorable radiological outcome (Capanna 1-2). Recurrence with refracture occurred in 4 patients after ESIN removal. The overall complication rate was low.