SLR - November 2009 - Chanel Houston
Reference:
Abuhassan, F.O., Shannak, A.O. (2009). Subperiosteal resection of aneurysmal bone cysts of the distal fibula. The Journal of Bone and Joint Surgery (British), 91-B(9), 1227-1231.
Scientific Literature Review
Reviewed by: Chanel Houston, DPM
Residency Program: Yale New Haven/DVA Healthcare System
Podiatric Relevance:
This article focuses on the role of periosteum in the regeneration of bone defects, rather than bone grafting, in the treatment of aneurysmal bone cysts of the distal fibula in pediatric patients.
Methods:
Eight pediatric patients averaging 13.5 years of age were studied. Each patient was diagnosed as having an active aneurysmal bone cyst based on the appearance of fluid drained from the cyst after preoperative aspiration, in addition to histological examination of the resected lesion. Further diagnosis was then confirmed by the classic radiographic appearance of ballooning in the distal fibula. Only one patient from the study had a closed growth plate as seen on plain film radiographs. All patients received the same surgical procedure of subperiosteal resection without reconstruction or bone grafting. The average size the resected specimen was 5.12 cm.
Results:
Following operative intervention, all eight patients had complete regeneration of the bone defect within three to nine months. No patients experienced lesion recurrence nor was there any injury to the growth plate. Furthermore, ankle joint range of motion and stability, when compared to the contralateral side, was normal. Once the defect was filled and ossified, complete healing was obtained.
Conclusions:
The most common treatments for aneurysmal bone cysts are curettage and bone grafting , but recurrence rates are high with these options. This article shows that subperiosteal resection is a viable treatment option for aneurysmal bone cyst, in that it allows for total regeneration of the bone defect and the absence of local recurrence without need for bone grafting.