Michalik Roman, Hildebrand Frank, Delbrück Heide
Department of Orthopaedic, Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, D-52074 Aachen, Germany.
Children (Basel). 2022 Dec 9;9(12):1932. doi: 10.3390/children9121932.
Aneurysmal bone cyst (ABC) is a benign osseus lesion with a high pathologic fracture risk. The described treatment options are varied and inconsistent. For successful treatment results, it is essential to prevent recurrence and sufficiently stabilise the weakened bone. Lesions close to the growth plates, especially in the femoral neck region, are challenging to stabilise in children. In this study, 27 clinics, including 11 sarcoma centres, 15 paediatric orthopaedic clinics, and one sarcoma/paediatric orthopaedic centre, were surveyed and asked about their treatment approaches for an exemplary case of ABC in the femoral neck causing a pathological fracture in a 20-month-old infant, with a response rate of 81%. The heterogeneity of treatment options described in the literature is consistent with the survey results. The most favoured approach was curettage, defect filling of any kind, and surgical stabilisation. However, the lesion stabilisation option introduced in this paper, which involves the use of transphyseal screws, was not mentioned in the survey and has not been reported in the literature. Contrary to the existing concepts, our technique offers high stability without significant growth restriction. Transphyseal screws are also suitable for the treatment of femoral neck fractures of other aetiologies in children.
动脉瘤样骨囊肿（ABC）是一种良性骨病变，具有较高的病理性骨折风险。所述的治疗选择多种多样且不一致。为获得成功的治疗效果，预防复发并充分稳定弱化的骨骼至关重要。靠近生长板的病变，尤其是在股骨颈区域，在儿童中稳定起来具有挑战性。在本研究中，对27家诊所进行了调查，其中包括11家肉瘤中心、15家小儿骨科诊所和1家肉瘤/小儿骨科中心，并询问了他们对于一名20个月大婴儿因股骨颈ABC导致病理性骨折的典型病例的治疗方法，回复率为81%。文献中描述的治疗选择的异质性与调查结果一致。最受欢迎的方法是刮除术、任何形式的缺损填充和手术稳定。然而，本文介绍的涉及使用经骨骺螺钉的病变稳定选项在调查中未被提及，且文献中也未报道。与现有概念相反，我们的技术提供了高稳定性且无明显生长受限。经骨骺螺钉也适用于治疗儿童其他病因的股骨颈骨折。
