Ossoscopy – a treatment method for juvenile bone cysts of the calcaneus

Autor: Dimnjaković, Damjan, Plečko, Mihovil, Knežević, Igor, Bojanić, Ivan
Jazyk: chorvatština
Rok vydání: 2019
Předmět:
Zdroj: Paediatria Croatica
Volume 63
Issue 3
ISSN: 1846-405X
1330-1403
Popis: Juvenilne koštane ciste (JKC) ubrajamo u skupinu benignih koštanih lezija koje se pojavljuju u djece. Kalkaneus je prema učestalosti treća lokalizacija pojave JKC-a. Više od 60% JKC-a kalkaneusa je asimptomatsko, a kad su simptomatske, očituju se povremenom bolnošću, osjetljivošću na palpaciju te povremenim lokalnim naticanjem. Odluka o načinu liječenja JKC-a kalkaneusa donosi se na osnovi veličine ciste i bolesnikovih simptoma. Kritična veličina JKC-a kalkaneusa definira se kada cista na magnetskoj rezonanciji zahvaća 100% poprečnog presjeka kalkaneusa u koronarnoj ravnini te barem 30% u sagitalnoj ravnini. Ciste takve veličine postaju simptomatske i zbog znatno većeg rizika nastanka patološke frakture savjetuje se njihovo kirurško liječenje. Najčešće primijenjena metoda kirurškog liječenja JKC-a kalkaneusa je otvoreni zahvat, tijekom kojeg se nakon detaljnog čišćenja i kiretaže ciste preostala šupljina u kosti ispuni autolognim ili homolognim koštanim presatkom. No danas se endoskopski zahvat smatra jednakovrijednom opcijom liječenja JKC-a kalkaneusa, a budući da se taj endoskopski zahvat čini u šupljini kosti, naziva se ososkopijom. Bolesniku u dobi od 14 godina dijagnosticirana je cista u kalkaneusu koja je na magnetskoj rezonanciji zahvaćala čitav poprečni presjek kosti, i na koronarnim i transverzalnim presjecima, te više od 30% poprečnog presjeka kalkaneusa na sagitalnom presjeku. Ososkopski mu je obavljena kiretaža ciste, a preostala šupljina u kosti mu je ispunjena homolognim koštanim presatkom. U radu se detaljno opisuje primijenjena operacijska tehnika uz pregled literature radi vrednovanja uspješnosti provedene metode u odnosu na druge opisane metode kirurškog liječenja JKC-a kalkaneusa.
Juvenile bone cysts (JBCs) are benign bone lesions that occur in children. Calcaneus is the third most frequent location in the body where they may present. More than 60% of JBCs of the calcaneus are asymptomatic, and when they become symptomatic, they usually cause pain, tenderness on palpation and occasional local swelling. Decision on managing JBC of the calcaneus is based on the size of the cyst and patient’s symptoms. The critical size of calcaneal JBC is defined when the cyst affects 100% of the intracalcaneal cross section in the coronary plane and at least 30% in the sagittal plane. Cysts of this size tend to become symptomatic and have an increased risk of developing a pathological fracture, therefore, it is advised to manage those cysts surgically. The most frequently used management approach for JBCs of the calcaneus is open curettage combined with augmentation using autograft or allograft bone transplantation. However, endoscopic method is nowadays considered as effective as the open approach. Because this endoscopic method is performed inside the bone cavity, it is called ‘ossoscopy’. A 14-year-old boy was diagnosed with a JBC in the calcaneus which affected the whole intracalcaneal cross section both in coronary and transverse planes, as well as more than 30% of the intracalcaneal cross section in the sagittal plane. Curettage of the cyst was performed ossoscopically, combined with augmentation using allograft bone transplant. The operative technique performed is described in this article together with a literature review evaluating this technique in comparison with other surgical techniques for the management of calcaneal JBCs.
Databáze: OpenAIRE
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