Are Fibular Allograft Struts Useful for Unicameral Bone Cysts of the Proximal Humerus in Skeletally Mature Patients?

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Khodamorad Jamshidi ◽  
Mehrdad Bahradadi ◽  
Marjan Bahrabadi ◽  
Alireza Mirzaei
Keyword(s):  
2013 ◽  
Vol 22 (5) ◽  
pp. 475-480 ◽  
Author(s):  
Soo-Min Cha ◽  
Hyun-Dae Shin ◽  
Kyung-Cheon Kim ◽  
Dong-Hun Kang

2020 ◽  
Vol 4 (1) ◽  
pp. 52-56
Author(s):  
Lucas Fraga ◽  
Rogério Barros ◽  
Roberto Maia ◽  
Marcus Santos ◽  
Rodrigo Martins

Os cistos ósseos simples são, em regra, assintomáticos e encontrados incidentalmente, embora possam causar dor, edema, rigidez da articulação adjacente ou estarem associados a um quadro de fratura patológica. A curetagem é o modo mais comum de tratamento. O defeito ósseo após curetagem deve ser preenchido com enxertos ósseos ou substitutos, como hidroxiapatita, fosfato tricálcico e cimento. Entretanto, a falha no tratamento pode ser devastadora para o ombro, em decorrência da perda biomecânica da área. Assim, a reconstrução do úmero proximal, após a ressecção do cisto, é um grande desafio para o cirurgião ortopédico. Este caso relata a colocação de uma prótese reversa de ombro (PRO), realizada após a falha do tratamento de um cisto ósseo simples, como uma solução eficiente para a reparação do problema.   Simple bone cyst are commonly asymptomatic and incidentally found, although they can cause pain, edema, stiffness of the adjacent joint or be associated with a pathological fracture. Curettage is the most common way of treating simple bone cysts. The bone defect after curettage must be filled with bone grafts or substitutes such as hydroxyapatite, tricalcium phosphate and cement. However, treatment failure can be devastating for the shoulder, due to the biomechanical loss of the area. Thus, the reconstruction of the proximal humerus after resection of the cyst is a major challenge for the orthopedic surgeon. This case reports the placement of a reverse shoulder prosthesis (PRO), performed after the failure of the treatment of a simple bone cyst, as an efficient solution to the problems related to the failure of treatment for the simple bone cyst.


2018 ◽  
Vol 26 (2) ◽  
pp. 230949901877836 ◽  
Author(s):  
Min-Cheol Kim ◽  
Sang-Don Joo ◽  
Sung-Taek Jung

Purpose: To evaluate the role of fractures on pathologic bone in healing of proximal humerus unicameral bone cysts (UBCs) and investigate the clinical factors that affect healing of UBCs after fractures on pathologic bone. Methods: This prospective study was carried out between 2002 and 2014. We evaluated 56 patients with a UBC accompanying fractures on pathologic bone in the proximal humerus. Clinical data were collected from the patients’ medical records. Age, gender, degree of fracture displacement, location of cyst, and cyst size were investigated, and we assessed how these factors affected cyst healing. Results: The overall healing rate of UBCs 1 year after fracture was 66% (37 of 56 cases). The healing rate was significantly lower in pubescent patients (10–14 years old; 45%) than in those who were 9 years old (76%) or 15 years old (80%). The rate of healing of fractures in the metaphysis (53%) was lower than that of breaks in the diaphysis (85%). The mean cyst ratio was 1.31 in the 37 patients who experienced cyst healing within 1 year and 1.79 in the 19 patients who needed surgical treatment within 1 year. Conclusion: In latent lesions and in patients who are older (after puberty), UBCs of the humerus after fracture have better clinical results than do active lesions and those in younger patients (before puberty). Fractures on pathologic bone in proximal humerus UBCs often dramatically decrease cyst size, and patients with such fractures have excellent clinical results in terms of healing rate.


2017 ◽  
Vol 11 (1) ◽  
pp. 486-492 ◽  
Author(s):  
Kenneth R. Gundle ◽  
Etasha M. Bhatt ◽  
Stephanie E. Punt ◽  
Viviana Bompadre ◽  
Ernest U. Conrad

Background:Many treatment options exist for unicameral bone cysts (UBC), without clear evidence of superiority. Meta-analyses have been limited by small numbers of patients in specific anatomic and treatment subgroups. The purpose of this study was to report the outcomes of injecting bone marrow aspirate and demineralized bone matrix (BMA/DBM) for the treatment of proximal humerus UBC.Methods:Fifty-one patients with proximal humerus lesions treated by BMA/DBM injection were retrospectively reviewed from a single academic medical center.Results:The mean number of injections performed per patient was 2.14 (range 1-5). Eleven patients underwent only one injection (22%), an additional 19 patients completed treatment after two injections (37%), four patients healed after three injections (8%), and one patient healed after four injections (2%). The cumulative success rate of serial BMA/DBM injections was 22% (11/51), 58% (30/51), 67% (34/51), and 69% (35/51). Eleven patients (22%) ultimately underwent open curettage and bone grafting, and five patients (10%) were treated with injection of calcium phosphate bone substitute.Conclusion:A BMA/DBM injection strategy avoided an open procedure in 78% of patients with a proximal humerus UBC. The majority of patients underwent at least 2 injection treatments.Level of Evidence:Level IV retrospective cohort study.


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