Zhou JianWu, Ning ShangKun, Su Yuxi, Liu Chuankang
Department of Oncology; Chongqing Key Laboratory of Pediatrics; Ministry of Education Key Laboratory of Child Development and Disorders; National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders; Children's Hospital of Chongqing Medical University, Chongqing, China.
Department of Orthopedics, Chongqing Key Laboratory of Pediatrics, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders; China International Science and Technology Cooperation Base of Child Development and Critical Disorders, The Children's Hospital of Chongqing Medical University, Chongqing, China.
J Child Orthop. 2021 Feb 1;15(1):55-62. doi: 10.1302/1863-2548.15.200184.
The aetiology of unicameral bone cysts (UBCs) is unclear. This study aims to evaluate the feasibility of elastic intramedullary nailing (EIN) combined with injections of methylprednisolone acetate (MPA) for the treatment of UBCs in children.
We retrospectively analyzed 53 children with UBCs in our hospital between January 2010 and April 2016. A total of 24 patients (Group A) were treated by EIN and MPA, whilst 29 patients (Group B) were treated by curettage, bone grafts and EIN fixation. The radiographs of the UBCs were evaluated following the Capanna criteria. All patients were followed-up on the third, sixth, 12th, 24th and 36th months. Fixation time, hospitalization time and complications were evaluated.
In Group A, the mean number of MPA injections was 1.8 (1 to 3). Based on radiographic evaluation, eight patients were healed (Capanna grade I), 14 were healed with residual cysts (Capanna grade II), one showed recurrence (Capanna grade III) and one showed no response to the treatment (Capanna grade IV). In Group B, 11 patients were evaluated as Capanna grade I, 12 as Capanna grade II, three as Capanna grade III and three as Capanna grade IV. There was significant difference in the early postoperative function activity (p < 0.001), hospitalization time (p = 0.028), blood loss during surgery (p < 0.001) and surgery time (p < 0.001).
The combination of EIN and MPA for the treatment of UBCs in children is feasible, has little operative trauma, short surgery time, short hospitalization time, less blood loss and a low risk of incision infection.
III.
单房性骨囊肿（UBC）的病因尚不清楚。本研究旨在评估弹性髓内钉（EIN）联合醋酸甲基泼尼松龙（MPA）注射治疗儿童UBC的可行性。
回顾性分析2010年1月至2016年4月我院收治的53例UBC患儿。其中24例患者（A组）采用EIN联合MPA治疗，29例患者（B组）采用刮除、植骨及EIN内固定治疗。根据卡潘纳标准对UBC的X线片进行评估。所有患者在术后第3、6、12、24和36个月进行随访。评估固定时间、住院时间及并发症情况。
A组MPA平均注射次数为1.8次（1至3次）。根据影像学评估，8例患者愈合（卡潘纳I级），14例患者愈合但有残留囊肿（卡潘纳II级），1例复发（卡潘纳III级），1例对治疗无反应（卡潘纳IV级）。B组中，11例患者评估为卡潘纳I级，12例为卡潘纳II级，3例为卡潘纳III级，3例为卡潘纳IV级。术后早期功能活动（p<0.001）、住院时间（p=0.028）、术中出血量（p<0.001）及手术时间（p<0.001）方面存在显著差异。
EIN联合MPA治疗儿童UBC是可行的，手术创伤小，手术时间短，住院时间短，出血量少，切口感染风险低。
III级。
