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采用单根弹性髓内钉治疗复发性肱骨骨囊肿

Single Flexible Nailing of the Humerus for Recurrent Bone Cysts.

作者信息

Talathi Nakul S, Kuka Casey C, Arkader Alexandre

机构信息

Children's Hospital of Philadelphia, Philadelphia, PA, USA.

出版信息

J Pediatr Soc North Am. 2025 Jun 10;12:100218. doi: 10.1016/j.jposna.2025.100218. eCollection 2025 Aug.

Abstract

UNLABELLED

Unicameral bone cysts (UBCs) in the proximal humerus are prone to pathologic fractures. We have discovered that using a single flexible nail, along with comprehensive curettage and grafting of humeral UBCs, is effective for safeguarding the bone and facilitating an early return to activity. Employing just one nail offers several advantages: technical simplicity in contouring and inserting a single nail, reduced surgical time, and elimination of a medial distal humeral dissection while ensuring stable internal fixation and promoting early motion even in cases of cyst recurrence. Our indications, surgical techniques, and helpful tips are outlined in this article.

KEY CONCEPTS

(1)Curettage and flexible intramedullary nailing with a single nail for treating pediatric humeral unicameral bone cysts is an effective prophylactic fixation strategy.(2)This enables ongoing activity even in the presence of cyst recurrence;-; in essence, "protect the bone and forget the cyst."(3)The judicious use of fluoroscopy, the appropriate starting point, and a suitably bent flexible nail allow for the straightforward passage of the nail into the humerus.

摘要

未标注

肱骨近端的单房性骨囊肿(UBCs)易于发生病理性骨折。我们发现,使用单根弹性髓内钉,同时对肱骨UBCs进行全面刮除和植骨,对于保护骨骼和促进早期恢复活动是有效的。仅使用一根钉子有几个优点:在塑形和插入单根钉子方面技术简单,手术时间缩短,消除了肱骨远端内侧的解剖,同时即使在囊肿复发的情况下也能确保稳定的内固定并促进早期活动。本文概述了我们的适应症、手术技术和实用技巧。

关键概念

(1)用单根钉子进行刮除和弹性髓内钉固定治疗小儿肱骨单房性骨囊肿是一种有效的预防性固定策略。(2)即使囊肿复发也能继续活动;本质上就是“保护骨骼,忘掉囊肿”。(3)合理使用透视、合适的起始点以及适当弯曲的弹性髓内钉可使钉子顺利进入肱骨。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e272/12305595/e9e65a16363f/gr1.jpg

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