Department of Pediatric Orthopedics, The Third Hospital of Hebei Medical University, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, China.
J Orthop Surg Res. 2021 Apr 6;16(1):241. doi: 10.1186/s13018-020-02130-6.
The primary aim of our study was to evaluate the comparative efficacy and safety profile of curettage and mixed bone grafting without instrument or with elastic intramedullary nailing in the treatment of humeral bone cyst in children.
Our retrospective study included a total of 48 children harboring humeral bone cyst in our hospital from August 2012 to February 2019. The patients enrolled were divided into elastic nailing group with the application of elastic intramedullary nailing (n = 25) and control group without using instrument (n = 23) during the management of curettage and mixed bone grafting. The following medical outcomes of the two groups were monitored and recorded: the amount of intraoperative blood loss, operation time and postoperative full weight-bearing time, in addition to postoperative clinical effects after 1 year, the function and pain level of shoulder joint before and 1, 3, 6, 9, 12, and 16 months after operation. Follow-up radiographic outcomes were reviewed to observe bone healing, local recurrence and internal fixation loosening, and other postoperative complications.
The clinical curative effect of the elastic nailing group was higher than that of the control group 16 months after operation (96.00% > 73.91%, P < 0.05). The intraoperative blood loss and postoperative full weight-bearing time in the elastic nailing group were less than those in the control group (P < 0.05), but the operation time was statistically insignificant between the two groups (P > 0.05). Before operation, the shoulder joint function of the two groups was comparable (P > 0.05), while the function showed remarkably better outcome in the elastic nailing group than control group 1 to 16 months after operation (P < 0.05). Before operation, the pain level of the two groups was comparable (P > 0.05), while 1 to 16 months after operation, the pain level of the elastic nailing group was significantly lower than that of the control group (P < 0.05). Patients in both groups were followed up for 16 months. Mixed bone grafting fusion was indicated by imaging CT and X-ray during the follow-up period, with an average fusion time of 11.3 ± 1.2 months (range, 8-16 months). Three months after operation, there was 1 case of incomplete pathological fracture in the control group, while no related complications occurred in the elastic nailing group. Moreover, no tumor recurrence was observed in the two groups. The two groups were comparable in terms of the incidence of complications (P > 0.05).
Children with humeral cyst treated with curettage and mixed bone grafting with the additional use of elastic intramedullary nailing exerted superior results to those without using instrument as there are beneficial outcomes and safety profile and no complications.
本研究的主要目的是评估刮除术联合混合植骨术治疗儿童肱骨骨囊肿时，使用弹性髓内钉与不使用器械的疗效和安全性。
本回顾性研究纳入 2012 年 8 月至 2019 年 2 月期间我院收治的 48 例肱骨骨囊肿患儿，将患者分为弹性钉组（应用弹性髓内钉，n = 25）和对照组（不使用器械，n = 23），在刮除术联合混合植骨术中分别采用弹性髓内钉和不使用器械治疗。监测并记录两组患者的术中出血量、手术时间和术后完全负重时间，以及术后 1 年的临床疗效、术后 1、1、3、6、9、12 和 16 个月时肩关节功能和疼痛水平。随访影像学结果观察骨愈合、局部复发和内固定松动等术后并发症。
术后 16 个月时，弹性钉组的临床疗效高于对照组（96.00% > 73.91%，P < 0.05）。弹性钉组的术中出血量和术后完全负重时间少于对照组（P < 0.05），但两组的手术时间无统计学差异（P > 0.05）。术前两组肩关节功能比较，差异无统计学意义（P > 0.05），术后 1 至 16 个月时，弹性钉组的肩关节功能明显优于对照组（P < 0.05）。术前两组疼痛程度比较，差异无统计学意义（P > 0.05），术后 1 至 16 个月时，弹性钉组的疼痛程度明显低于对照组（P < 0.05）。两组患者均随访 16 个月。影像学 CT 和 X 线检查显示，两组均有混合植骨融合，平均融合时间为 11.3 ± 1.2 个月（8 至 16 个月）。术后 3 个月，对照组有 1 例不完全性病理骨折，弹性钉组无相关并发症。此外，两组均未见肿瘤复发。两组并发症发生率比较，差异无统计学意义（P > 0.05）。
肱骨骨囊肿患儿行刮除术联合混合植骨术，术中使用弹性髓内钉，疗效优于不使用器械，具有良好的效果和安全性，且无并发症。
