Department of Pediatric Orthopaedics and Foot and Ankle Surgery, Orthopaedic Hospital Speising, Speisingerstraße 109, 1130, Vienna, Austria.
Int Orthop. 2024 Jun;48(6):1619-1626. doi: 10.1007/s00264-024-06158-9. Epub 2024 Apr 4.
The aim of this study was to evaluate and compare different surgical treatment modalities for simple bone cysts (SBC) of the humerus regarding their effectiveness and recurrence rate.
In this retrospective study, patients who received surgical treatment for previously untreated primary SBCs of the humerus were analyzed. Demographic data, cyst-specific as well as treatment-specific parameters, complications, treatment failures, and recurrence rates were collected and correlated with different treatment modalities. Observed procedures were categorized as open procedure (n=20) or osteosynthesis alone (n=3). For the open procedure group, four subgroups could be defined.
Twenty-three patients were included. The mean age at diagnosis was 11.6 ± 2.5 years, and the mean postoperative follow-up was 3.9 ± 2.6 years (range 1.0-10.3). After surgical intervention, a total of five (21.7%) patients showed at least one recurrence. Fracture occurred in three (13.0%) cases. The incidence of treatment failure was significantly higher in the curettage, allograft, adjuvants group, with five (83.3%) of six cases showing recurrence, than in the other subgroups (≤ 25.0%) including the osteosynthesis alone group (p=.024). For the open procedure group, the failure-free survival rates were 80.0% after two years and 50.4% after five years. For the three cases treated by osteosynthesis alone, no failures were observed.
Open procedures showed similar failure rates except for the subgroup using curettage, allograft, and adjuvants which showed significantly higher treatment failure. Promising results were observed in the group which received solely osteosynthesis without cyst excision or filling, as no treatment failure was observed here.
本研究旨在评估和比较肱骨单纯性骨囊肿（SBC）不同手术治疗方法的疗效和复发率。
在这项回顾性研究中，分析了接受手术治疗的肱骨未治疗原发性单纯性骨囊肿患者。收集了人口统计学数据、囊肿特异性和治疗特异性参数、并发症、治疗失败和复发率，并与不同的治疗方法相关联。观察到的手术分为开放式手术（n=20）或单纯内固定（n=3）。对于开放式手术组，可分为四个亚组。
共纳入 23 例患者。诊断时的平均年龄为 11.6±2.5 岁，术后平均随访 3.9±2.6 年（范围 1.0-10.3）。手术后，共有 5 例（21.7%）患者至少有一次复发。3 例（13.0%）发生骨折。在刮除、同种异体骨、辅助剂组中，治疗失败的发生率明显更高，6 例中有 5 例（83.3%）出现复发，而其他亚组（≤25.0%）包括单纯内固定组（p=.024）。对于开放式手术组，两年后无失败生存率为 80.0%，五年后为 50.4%。在单纯接受内固定治疗的 3 例中，未观察到失败。
除了使用刮除、同种异体骨和辅助剂的亚组显示出明显更高的治疗失败率外，开放式手术的失败率相似。单纯接受内固定而不切除或填充囊肿的患者组观察到了有希望的结果，因为这里没有观察到治疗失败。
