Graduate School, Tianjin Medical University, Heping District, Tianjin, 300070, People's Republic of China.
Department of Orthopedics, Tianjin Hospital, Jiefang South Road 406, Hexi district, Tianjin, 300211, People's Republic of China.
BMC Musculoskelet Disord. 2020 Feb 4;21(1):70. doi: 10.1186/s12891-020-3054-6.
Simple bone cysts (SBCs) are common benign lytic bone lesions in children. This study focused on exploring a clinical treatment method, minimally invasive intramedullary decompression and drainage with elastic stable intramedullary nailing (ESIN) combined with intralesional injections of steroids, and evaluated its effectiveness, complications and morbidity through functional and radiographic outcomes.
The postoperative recovery of 18 children who suffered from SBCs of humerus was evaluated (mean follow-up, 40 months) from January 2009 to December 2016. These patients (11 males, 7 females; 8 in the left, 10 in the right; mean age, 10.9 years old) were treated with minimally invasive intramedullary decompression and drainage with ESIN combined with intralesional injections of steroids. The diagnosis was based on not only pre-operative typical medical images (X-rays/CT/MRI) but also surgical findings and pathological diagnosis. Radiological and functional outcomes were evaluated according to Capanna and Musculoskeletal Tumor Society (MSTS) score. The interclass differences were analyzed by t-test.
According to Capanna and MSTS criteria, after treatment, 14 patients made full recoveries which was presented by all the cysts filled with bone tissue, and 4 patients made partially recoveries, which were presented by cystic spaces partially filled with low density bone. All the cysts responded to treatment method, and there was no cyst recurrence. All except 2 patients had good functional results. One of the two patients had irritation of the end of the nail and one patient had a valgus deformity.
Treatment for SBCs of humerus by minimally invasive intramedullary decompression and drainage with ESIN combined with intralesional injections of steroids is safe, effective and convenient. The clinical effect is satisfactory and worth popularizing.
单纯性骨囊肿（SBC）是儿童常见的良性溶骨性骨病变。本研究旨在探讨一种临床治疗方法，即微创髓内减压和引流联合弹性稳定髓内钉（ESIN）治疗单纯性骨囊肿，并通过功能和影像学结果评估其疗效、并发症和发病率。
2009 年 1 月至 2016 年 12 月，对 18 例肱骨干单纯性骨囊肿患儿（平均随访时间 40 个月）的术后恢复情况进行评估。这些患者（男 11 例，女 7 例；左侧 8 例，右侧 10 例；平均年龄 10.9 岁）采用微创髓内减压和引流联合 ESIN 治疗，并结合病灶内类固醇注射。诊断不仅基于术前典型的影像学（X 线/CT/MRI），还基于手术发现和病理诊断。根据 Capanna 和肌肉骨骼肿瘤学会（MSTS）评分评估影像学和功能结果。采用 t 检验分析组间差异。
根据 Capanna 和 MSTS 标准，治疗后 14 例患者完全恢复，表现为所有囊肿均被骨组织填满，4 例患者部分恢复，表现为囊性空间部分被低密度骨填满。所有囊肿均对治疗方法有反应，无囊肿复发。除 2 例患者外，所有患者的功能结果均良好。其中 1 例患者的钉端受刺激，1 例患者出现外翻畸形。
微创髓内减压和引流联合 ESIN 治疗肱骨干单纯性骨囊肿安全、有效、方便。临床效果满意，值得推广。
