OBJECTIVE: Definitive bony consolidation in juvenile bone cysts. Prevention of pathologic fractures. Preservation of limb function. INDICATIONS: Juvenile bone cysts at all sites. CONTRAINDICATIONS: Malignant cystic lesions. SURGICAL TECHNIQUE: After opening and curettage, the cyst is packed with human demineralized bone matrix (DBM). POSTOPERATIVE MANAGEMENT: Clinical and radiologic checks after 1, 4, and 6 months, followed by further 6-monthly checks. RESULTS: Over a period of 2 years, nine cysts packed with DBM showed almost totally osteodense images after an average of 8 months, with no other significant changes (follow-up period: 24 months). A typical decrease in cyst transparency on the plain radiographs was already detectable in all patients after 3-4 months. Marked cortical remodeling was visible after 6 months. A significant complication in one cyst in the distal tibial region was a pathologic fracture following distortion trauma; this occurred after 5 months, probably because of insufficient filling of the cyst. The fractured limb was immobilized in a lower-leg cast and healed sufficiently for stable weight bearing after 12 weeks.
OBJECTIVE: Definitive bony consolidation in juvenile bone cysts. Prevention of pathologic fractures. Preservation of limb function. INDICATIONS: Juvenile bone cysts at all sites. CONTRAINDICATIONS: Malignant cystic lesions. SURGICAL TECHNIQUE: After opening and curettage, the cyst is packed with human demineralized bone matrix (DBM). POSTOPERATIVE MANAGEMENT: Clinical and radiologic checks after 1, 4, and 6 months, followed by further 6-monthly checks. RESULTS: Over a period of 2 years, nine cysts packed with DBM showed almost totally osteodense images after an average of 8 months, with no other significant changes (follow-up period: 24 months). A typical decrease in cyst transparency on the plain radiographs was already detectable in all patients after 3-4 months. Marked cortical remodeling was visible after 6 months. A significant complication in one cyst in the distal tibial region was a pathologic fracture following distortion trauma; this occurred after 5 months, probably because of insufficient filling of the cyst. The fractured limb was immobilized in a lower-leg cast and healed sufficiently for stable weight bearing after 12 weeks.