The clinical application of bone cement for special bone diseases in children

XIA Tian; NING Bo; SONG Jun; PEI Xin-hong; WANG Da-hui; MA Rui-xue

doi:10.3969/j.issn.2095-252X.2017.06.011

Abstract：Objective To explore the therapeutic effects of bone cement filling for bone diseases in children when bone graft is infeasible. Methods Between May 2012 and May 2016, 10 children ( 11 sites ) with bone diseases underwent bone cement filling. There were 8 males and 2 females, whose mean age was 8.2 years ( range: 2 - 15 years ) at the time of operation. There were 7 cases of infections, including 4 cases of bone tuberculoses and 3 cases of nonspecific infections, and 3 cases of tumors and tumor-like lesions, including 2 cases of chondroblastoma and 1 case of osteofibrous dysplasia. The sites were located in the femur ( n = 5 ), tibia ( n = 3 ), ulna ( n = 1 ), ilium ( n = 1 ) and acetabulum ( n = 1 ). During the operation, frozen surgical pathologic specimens were taken. If infection or benign aggressive bone tumor was confirmed after frozen-section diagnosis, the patient would be treated by curettage and bone cement filling. Besides that, the external fixator and intramedullary nail were used for 1 case. The involved limbs were fixed in the cast for 6 to 12 weeks. Bone cement hadn't been removed until now. Results The mean follow-up time was 22.4 months ( range: 6 - 36 months ). There was no recurrence or pathological fracture. The patients no longer suffered from pain, and the range of motion of the joint was improved. All the patients whose lower limb bone got involved could walk. Leg length discrepancy and ankle varus were noted in 1 patient with chronic osteomyelitis at 1 year after operation because the epiphyseal plate of the distal tibia was destroyed. Bone line was fine in all the other children. Conclusions Bone cement filling is an effective method to treat infections and tumor-like lesions that cannot be treated by bone graft in children, which can relieve patients' clinical symptoms and reduce the recurrence rate. This is a good treatment option for intractable bone diseases in children.