Treatment of simple bone cysts with methylprednisolone acetate in children

Guney YİLMAZ; Cemalettin AKSOY; Ahmet ALANAY; Muharrem YAZİCİ; A. ALPASLAN

Article Details

Treatment of simple bone cysts with methylprednisolone acetate in children

Authors:

Guney YİLMAZ | Cemalettin AKSOY | Ahmet ALANAY | Muharrem YAZİCİ | A. ALPASLAN

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2005 Vol.39 Issue 5, pp.411-415

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000812620

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X

Keywords:

Abstract:

 

Objectives: Steroid injections represent one of the simple treatment alternatives for simple bone cysts in pediatric age group. The aim of this study was to evaluate the results of steroid injections in the treatment of simple bone cysts.
Methods: Thirteen children (9 boys, 4 girls; mean age 9 years; range 4 to 14 years) with simple bone cysts were treated primarily with injection of methylprednisolone acetate with the use of the two-needle technique. The cysts were localized in the proximal humerus (n=7), femoral intertrochanteric region (n=4), and the proximal one-third of the femur (n=1). Four patients had fractures before treatment. Each patient received a maximum of three injections at six-week intervals, each consisting of 120-160 mg of methylprednisolone acetate. The patients were monitored by plain radiographs obtained in the sixth week, third month, sixth month, and at the end of a year followed by annual radiographic evaluations. Cyst healing was assessed according to the Neer classification. The mean follow-up was five years (range 1 to 11 years).
Results: Treatment with methylprednisolone acetate resulted in complete healing in five patients (38.5%) and healing with residual lesions in six patients (46.2%). One patient (7.7%) did not respond to steroid treatment and one patient developed recurrence. The results were satisfactory (84.6%) in patients with complete healing and healing with residual lesions, and unsatisfactory in two patients (15.4%). No procedure-related complications were encountered. 
Conclusion: Our results suggest that treatment with steroid injections offers satisfactory outcome in simple bone cysts in children, and thus, is worthy of consideration before more aggressive methods are to be applied.

 

Amaç: Çocukluk çağında görülen basit kemik kistlerinde kist içine steroid enjeksiyonu basit tedavi seçeneklerinden biridir. Bu çalışmada, basit kemik kistlerinin tedavisinde steroid enjeksiyonunun sonuçları değerlendirildi.
Çalışma planı: Basit kemik kisti saptanan 13 çocuk hasta (9 erkek, 4 kız; ort. yaş 9; dağılım 4-14) iki iğne tekniği kullanılarak kist içine metilprednisolon asetat enjeksiyonuyla tedavi edildi. Kist yedi olguda humerus proksimali, dört olguda femur intertrokanterik bölge, bir olguda 1/3 proksimal femur cisminde yerleşmişti. Dört hastada steroid enjeksiyonu öncesinde patolojik kırık oluşmuştu. Hastalara altı hafta arayla, herbiri 120-160 mg metilprednisolon asetat içeren en fazla üç enjeksiyon uygulandı. Enjeksiyon sonrasında altıncı haftada, üçüncü ayda, altıncı ayda ve birinci yılda düz grafiler çekildi. İlk yıldan sonra hastalar yılda bir kez grafilerle takip edildi. Kist iyileşmesi Neer sınıflandırmasına göre değerlendirildi. Hastaların ortalama takip süresi 5 yıl (dağılım 1-11 yıl) idi. 
Sonuçlar: Metilprednisolon asetat tedavisi beş hastada (%38.5) tamamen, altı hastada (%46.2) rezidüel lezyonla iyileşme sağladı. Bir hasta (%7.7) steroide hiç yanıt vermedi; bir hastada kist tekrarladı. Tamamen veya rezidüel lezyonla iyileşen hastalardaki sonuçlar tatminkar bulunurken (%84.6), iki hastada (%15.4) başarısız bulundu. İşlemle ilgili hiçbir hastada komplikasyon görülmedi.
Çıkarımlar: Bulgularımız, çocuklarda görülen basit kemik kistlerinde steroid enjeksiyonunun tatmin edici sonuçlar sağladığını ve agresif tedaviler öncesinde düşük morbiditeli bu tedavinin denenebileceğini göstermektedir.

Article Details

Treatment of simple bone cysts with methylprednisolone acetate in children

Authors:

Guney YİLMAZ | Cemalettin AKSOY | Ahmet ALANAY | Muharrem YAZİCİ | A. ALPASLAN

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2005 Vol.39 Issue 5, pp.411-415

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000812620

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X

Bone cysts/drug therapy;child; injections

intralesional; methylprednisolone/therapeutic use;steroids/therapeutic use

Issues

Article Details

Treatment of simple bone cysts with methylprednisolone acetate in children

Authors: Guney YİLMAZ | Cemalettin AKSOY | Ahmet ALANAY | Muharrem YAZİCİ | A. ALPASLAN

Publisher: Turkish Association of Orthopaedics and Traumatology

Journal: Acta Orthopaedica et Traumatologica Turcica 2005 Vol.39 Issue 5, pp.411-415

Document Type: Article

Publication Date: 9/2006

Document Language: English

Document ID (Org No.): 2000812620

Frequency: Bimonthly

eISSN: 1017-995X

pISSN: 1017-995X

Bone cysts/drug therapy;child; injections

intralesional; methylprednisolone/therapeutic use;steroids/therapeutic use

Issues

Authors:

Guney YİLMAZ | Cemalettin AKSOY | Ahmet ALANAY | Muharrem YAZİCİ | A. ALPASLAN

Publisher:

Turkish Association of Orthopaedics and Traumatology

Journal:

Acta Orthopaedica et Traumatologica Turcica 2005 Vol.39 Issue 5, pp.411-415

Document Type:

Article

Publication Date:

9/2006

Document Language:

English

Document ID (Org No.):

2000812620

Frequency:

Bimonthly

eISSN:

1017-995X

pISSN:

1017-995X