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. 2011 Apr;5(2):151-6.
doi: 10.1007/s11832-010-0323-1. Epub 2011 Jan 8.

Distance from the growth plate and Its relation to the outcome of unicameral bone cyst treatment

Saadallah George Haidar, David J Culliford, Edward David Gent, Nicholas M P Clarke

Distance from the growth plate and Its relation to the outcome of unicameral bone cyst treatment

Saadallah George Haidar et al. J Child Orthop. 2011 Apr.

Abstract

Background: Interventions to treat unicameral bone cysts vary. Nonetheless, regardless of the intervention modality, the outcome is not certain. The purpose of this study was to determine if the distance between the growth plate and the cyst can be used to predict the outcome of the treatment.

Methods and materials: Retrospectively, we assessed the outcome of 39 interventions in nineteen children that were performed between 1994 and 2003. Seventeen different modalities of treatment were employed. There were three female and sixteen male patients. The average age was 8 years. Nine cysts were in the greater trochanter area, three were in the femoral capital area and seven were in the proximal humerus. According to the cyst's distance from the growth plate, at the intervention time, there were 18 cases within less than 2 cm and 21 cases of more than 2 cm.

Results: Complete healing was achieved in 10 children (employing seven different modalities). In nine of them, the cysts were more than 2 cm away from the growth plate. In one child, the cyst was within less than 2 cm of the growth plate, however, treatment here involved epiphyseodesis.

Discussion: This study confirmed that, regardless of intervention modality, complete healing was not achievable in those cysts that are within less than 2 cm of an active growth plate. Complete healing was possible in those cysts that are more than 2 cm away from the growth plate.

Conclusion: The 2-cm distance from the growth plate could be used as a predictor of treatment outcome of unicameral bone cysts.

Keywords: Growth plate; Outcome; Predictor; Unicameral bone cyst.

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Figures

Fig. 1
Fig. 1
Healing grades according to the treatment modality
Fig. 2
Fig. 2
Healing grades according to the distance from the growth plate for 39 interventions
Fig. 3
Fig. 3
Outcome of the 19 children according to distance from growth plate at final follow up
Fig. 4
Fig. 4
Grade 4 healing in a case within 2 cm from growth plate following Epiphyseodesis
Fig. 5
Fig. 5
Cyst reactivation (a–c). CT scan showed that the cyst reaches the level of glenoid cavity and that it is within less than 2 cm from the growth plate (d)
Fig. 6
Fig. 6
Confounding case 3, Grade 4 healing and subsequent reactivation. Is there a cyst in the proximal medial corner of the femoral neck (C)
See this image and copyright information in PMC

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