Results of Allografts and Synthetic Grafts in Humeral Simple Bone Cysts.

Abstract

Purpose of the study: Simple bone cysts (SBCs) are the most common benign bone lesions in childhood. There are many different methods in the treatment of SBCs. There is no consensus on which method to use in the treatment. In this study, we compared the results of allogeneic bone graft or synthetic bone graft in addition to fl exible intramedullary nail (FIN) for SBC located in the humerus.

Material and methods: This retrospective study comparing the data of 19 (group 1: 8 curettage, allograft and FIN; group 2: 11 curettage, synthetic graft and FIN) patients with a mean age of 11.4 (6 to 26; seven female, twelve male) who were surgically treated in our hospital for humeral SBC between April 2014 and January 2020. Patient data included age, sex, anatomical side, stage of the cyst, pathological fracture, previous treatments and complications.

Results: The mean follow-up period was 33.7 months (12 to 61). The average last follow-up Musculoskeletal Tumor Society functional scores for groups 1 and 2 were 27.8 (20 to 30) and 28.6 (21 to 30) (P > 0.05). Complete or signifi cant partial radiographic healing rates were achieved in group 1 (75%) compared with group 2 (81.9%). The reoperation rates for groups 1 and 2 were 62.5% (5/8; three for nails removed, two for recurrence) and 36.3% (4/11; two for nails removed, two for recurrence). One patient in group 2 had a 15° varus deformity due to recurrence. No other complications were observed.

Conclusions: The combination of curettage-grafonage FIN is a common treatment method in recent years, as it provides early cyst healing and limb mobilization in SBCs located in the upper extremity. For defects after curettage of the bone cysts, allogeneic or synthetic grafts (granule b-tricalcium phospate) which have similar results in terms of healing can be used as an alternative to each other.

Key words: allografts, bone cysts, bone nails, synthetic grafts, humerus.