Results evaluation of hormone therapy of the bone cysts
LIU Wen-sheng
NIU Xiao-hui
DENG Zhi-ping
LI Yuan
YU Feng
WANG Tao
YANG Fa-jun
Abstract：Objective To study and summarize the curative effects of intralesional injection of methylprednisolone for the treatment of the bone cysts in different parts of the body. Methods 33 patients with bone cysts of intact data were adopted from May 2007 to July 2012, who were treated with intracapsular injection of methylprednisolone. There were 23 males and 10 females, whose mean age was 12.3 years old ( range;5-28 years ). All patients were followed up for a mean period of 31.3 months ( range;3-53 months ). The lesions of 10 cases were situated in the proximal femur, 1 case in the shaft of femur, 1 case in the distal ifbula, 2 cases in the ilium and 19 cases in the proximal humerus. 11 patients with pathological fractures were immobilized for 1-2 months, who received treatment when the fractures were healed. Before the treatment, 4 patients who were treated with curettage and bone graft reoccurred postoperatively. 2 of them were treated with curettage, bone graft and internal ifxation with steel plates. Before the treatment, routine aspiration biopsy was performed on all the patients, and hormone therapy was carried out when bone cysts were conifrmed. Before the treatment, venous general anesthesia was used. Under the guide of“C”-arm, 2 medullo-puncture needles were introduced into both sides of the lesions to scrape the bone wall and destroy the cyst membrane. The lesions were repeatedly washed by normal saline, and contrast medium was injected. When the lesions were in good comditions, contrast medium would be rushed. The volume of 100-200 mg methylprednisolone was determined by the size of the cystic cavity. The puncture needle was pressed for 3 minutes to prevent the hormonal exudation and compress the wound bandage. Results 30 patients were injected with different amounts of hormones for a mean of 2.5 times ( range;2-4 times ), and the interval time was 1-3 months. Postoperatively X-rays were reviewed every 2 months. According to the Neer classiifcation:27 patients ( 81.8%) were completely healed, 27 patients ( 81.8%) were healed with defects, and 4 patients had ineffective treatment. Among them, 2 patients had cysts healed after curettage and bone graft, and 1 patient received curettage, bone cement iflling and dynamic hip screw ( DHS ) internal ifxation. The treatment was terminated for 1 patient. 3 patients who had recurrence after cyst union accepted surgical treatment, whose cysts got healed postoperatively. 1 of the 4 patients who had postoperative recurrence received curettage and bone graft after the failure of hormone therapy for 3 times, and the cysts also got healed. 2 patients had lesions partially healed after infection therapy for 2-3 times. Another recurrence occurred to 1 patient who had cysts partially healed after hormone therapy for 3 times, and then the treatment was terminated. Among the 11 patients with pathological fractures who had hormone therapy after fracture union, 2 patients had surgical treatment after the failure of infection therapy for 2-3 times, and the other 9 patients had complete union or particle union. Conclusions It is an effective method to treat simple bone cysts with hormone infection. About 80%of patients can avoid surgical treatment, and got healed. Comparing with other treatment, it is the preferred method of treating simple bone cysts, with easy operation procedures and small trauma.
Keywords：Bone cystsTherapiesinvestigationalMethylprednisolon
Publication Date：2013-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 509-512 )