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Re: Солитарная костная киста
Alexander Chelnokov 11 Июнь 2009, 20:10
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Дорогая Екатерина Анатольевна,
В современной литературе закрытый интрамедуллярный остеосинтез позиционируется не только как профилактика перелома в области кисты, но и как ее патогенетическое лечение, поскольку ее разгерметизация и дренирование по ходу стержня (или стержней) способствуют репарации, создавая continuous decompression.
Недавняя публикация:
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J Child Orthop. 2008 Aug;2(4):279-83. Epub 2008 Jul 24.
Continuous decompression with intramedullary nailing for the treatment of unicameral bone cysts.
Masquijo JJ, Baroni E, Miscione H.
Department of Pediatric Orthopaedics, Hospital de Pediatría Juan P. Garrahan, Buenos Aires, Argentina, otihg@fibertel.com.ar.
PURPOSE: To evaluate the efficacy of decompression of unicameral bone cysts (UBCs) of the long bones with intramedullary nailing and to compare responses to treatment according to location. MATERIALS AND METHODS: We evaluated 48 consecutive patients treated between January 1988 and June 2000. Mean age was 10.3 years. Mean follow-up was 9.8 years. Evaluation was performed according to the radiographic criteria of Capanna.
RESULTS: UBCs were located in the proximal humerus (n = 24), humeral shaft (n = 2), proximal femur (n = 19), distal tibia (n = 2) and fibula (n = 1). A total of 62.5% presented a pathological fracture.
Successful results were observed in 89.5% (26 total healing, 17 healing with residual radiolucent areas), and there were four recurrences and, in one case, no response to treatment. There was more healing in the humerus than in the femur (92.3% versus 84.2%), and more tendency to restitution ad integrum, although the
difference was not statistically significant (P = 0.1499).
CONCLUSIONS: Intramedullary nailing is a minimally invasive method, which permits early
stability and decompresses the cyst allowing healing. Significant differences were not observed among results from different locations.
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Так что предложение сделать интрамедуллярный остеосинтез вполне здравое, и, по-моему, в институте уже делались такие операции.
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