Skip to main content

Advertisement

SpringerLink
Log in

Subperiosteal resection of fibular aneurysmal bone cyst

  • Original Article
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Aneurysmal bone cyst (ABC) of the fibula poses a challenge as to the most appropriate treatment particularly in children and adolescents. A prospective study was conducted to evaluate the results of subperiosteal resection of fibular ABCs. Eleven patients (six boys and five girls) with an average age of 12.4 years (6–18 years) were treated by subperiosteal resection of ABC of the fibula. The lesion was juxtaphyseal in three patients (two distal and one proximal), metaphyseal in seven and diaphyseal in one. All cysts were active and centrally located type 2. The modified Enneking scoring system was used for final functional evaluation while a scale proposed by the author was used for final radiological assessment. At the final follow-up, there was no difference in the range of movement, alignment or stability of the ankle or the knee when compared with the opposite side. Three patients complained of mild discomfort on heavy activity. One patient had failure of healing that was related to the use of suction drain. After a mean follow-up of 41.6 months (24–64 months), the mean functional score was 98.8 % (93–100 %). According to the proposed radiological scale, six patients were rated excellent, three good, one fair and one poor. In conclusion, subperiosteal resection is effective in eradicating fibular ABCs, regenerates a new bone and avoids the morbidity of other techniques.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Unni KK (1996) Dahlin’s bone tumors: general aspects and data on 11.087 cases. LippincottRaven, Philadelphia, pp 1–9

    Google Scholar 

  2. Capanna R, van Horn JR, Biagini R, Ruggieri P, Bettelli G, Campanacci M (1986) Reconstruction after resection of distal fibula for bone tumor. Acta Orthop Scand 57:290–294

    Article  CAS  PubMed  Google Scholar 

  3. Cottalorda J, Kohler R, Sales de Gauzy J, Chotel F, Mazda K, Lefort G, Louahem D, Bourelle S, Dimeglio A (2004) Epidemiology of aneurysmal bone cysts in children: a multicenter study and literature review. J Pediatr Orthop B 13:389–394

    Article  PubMed  Google Scholar 

  4. Lampasi M, Magnani M, Donzelli O (2007) Aneurysmal bone cysts of the distal fibula in children: long-term results of curettage and resection in nine patients. J Bone Joint Br 89:1356–1362

    Article  CAS  Google Scholar 

  5. Rizzo M, Delaero DT, Harreison JM, Scully SP (1999) Juxtaphyseal aneurysmal bone cysts. Clin Orthop 364:205–212

    Article  PubMed  Google Scholar 

  6. Ramirez N, Perez C, Rivera YC (2001) Distal fibular aneurysmal bone cyst: en bloc resection and proximal third fibular reconstruction. Am J Orthop 30:237–240

    CAS  PubMed  Google Scholar 

  7. Abdel MP, Papagelopoulos PJ, Morrey ME, Wengner DE, Rose PS, Sim FH (2010) Surgical management of 121 benign proximal fibula tumors. Clin Orthop Relat Res 468:3056–3062

    Article  PubMed Central  PubMed  Google Scholar 

  8. Dieckmann R, Gebert C, Streitbürger A, Henrichs M-P, Dirksen U, Rödl R, Gosheger G, Hardes J (2011) Proximal fibula resection in the treatment of bone tumors. Int Orthop 35:1689–1694

    Article  PubMed Central  PubMed  Google Scholar 

  9. Mavrogenis AF, Rossi G, Rimondi E, Ruggieri P (2012) Successful treatment of aneurysmal bone cyst of the proximal fibula with embolization. Eur J Orthop Surg Traum 22:199–204

    Article  Google Scholar 

  10. Mankin HJ, Hornicek FJ, Ortiz-Cruz E, Villafuerte J, Gebhadt MC (2005) Aneurysmal bone cyst: a review of 150 patients. J Clin Oncol 23:6756–6762

    Article  PubMed  Google Scholar 

  11. Cottalorda J, Bourette S (2007) Modern concepts of primary aneurysmal bone cyst. Arch Orthop Trauma Surg 127:105–114

    Article  PubMed  Google Scholar 

  12. Cottalorda J, Kohler R, Chotel F, de Gauzy JS, Lefort G, Louahem D, Bourelle S, Diméglio A (2005) Recurrence of aneurysmal bone cysts in young children: a multicenter study. J Pediatr Orthop B 14:212–218

    Article  PubMed  Google Scholar 

  13. Vergel De Dios AM, Bond JR, Shives TC, Mcleod RA, Unni KK (1992) Aneurysmal bone cyst. A clinicopathologic study of 238 cases. Cancer 69(12):2921–2931

    Article  CAS  PubMed  Google Scholar 

  14. Gibbs CP Jr, Hefele MC, Peabody TD, Montag AG, Aithal V, Simon MA (1999) Aneurysmal bone cyst of the extremities: factors related to local recurrence after curettage with a high-speed burr. J Bone Joint Surg Am 81:1671–1678

    PubMed  Google Scholar 

  15. Cottalorda J, Bourelle S (2006) Current treatments of primary aneurysmal bone cysts. J Pediatr Orthop B 15:155–167

    Article  PubMed  Google Scholar 

  16. Caso Martinez J, Gonzalez Acha J, Gonzalez Galarraga JI, Sarobe Andueza JM (1993) En-bloc resection of the distal fibula for aneurysmal bone cyst. Acta Orthop Belg 59:87–89

    CAS  PubMed  Google Scholar 

  17. Rizzo M, Scully SP, Harreison JM (1999) Ipsilateral fibular slide grafts in the management of distal fibular lesions. Foot Ankle Int 20:135–136

    Article  CAS  PubMed  Google Scholar 

  18. Erler K, Demiralp B, Ozdemir MT, Basbozkurt M (2004) Treatment of proximal fibular tumors with en bloc resection. Knee 11:489–496

    Article  PubMed  Google Scholar 

  19. Rapp TB, Ward JP, Alaia MJ (2012) Aneurysmal bone cyst. J Am Acad Orthop Surg 20:233–241

    Article  PubMed  Google Scholar 

  20. Shaji H, Koshino T, Marcove RC, Thompson TC (1970) Subperiosteal resection of the distal portion of the fibula for aneurysmal bone cysts: report of two cases. J Bone Joint Surg Am 52:1472–1476

    Google Scholar 

  21. Abuhassan FO, Shannak AO (2009) Subperiosteal resection of aneurysmal bone cysts of the distal fibula. J Bone Joint Surg Br 91:1227–1231

    Article  CAS  PubMed  Google Scholar 

  22. Capanna R, Bettelli G, Biagini R, Ruggieri P, Bertoni F, Campanacci M (1985) Aneurysmal bone cysts of long bones. Ital J Orthop Traumatol 11:409–417

    CAS  PubMed  Google Scholar 

  23. Enneking WF (1986) A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res 204:9–24

    PubMed  Google Scholar 

  24. Enneking WF, Dunham W, Gebhardt MG, Malawer M, Pritchard DJ (1993) A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res 286:241–246

    PubMed  Google Scholar 

  25. Rosenberg AE, Nielsen GP, Fletcher JA (2002) Aneurysmal bone cyst. In: Fletcher CDM, Unni KK, Mertens F (eds) World Health Organization: classification of tumors: pathology and genetics of tumors of soft tissue and bone. IARC Press, Lyon, pp 338–339

    Google Scholar 

  26. Ramirez AR, Stanton RP (2002) Aneurysmal bone cyst in 29 children. J Pediatr Orthop 22:533–539

    PubMed  Google Scholar 

  27. Kransdorf MJ, Sweet DE (1995) Aneurysmal bone cyst: concept, controversy, clinical presentation and imaging. Am J Roentgenol 164:573–580

    Article  CAS  Google Scholar 

  28. Wiltse LL (1972) Valgus deformity of the ankle: a sequel to acquired or congenital abnormalities of the fibula. J Bone Joint Surg Am 54:595–606

    CAS  PubMed  Google Scholar 

  29. Brosjo O, Pechom P, Hesla A, Tsagozis P, Bauer H (2013) Sclerotherapy with polidocanol for treatment of aneurismal bone cysts: good results in 37 of 38 consecutive patients. Acta Orthopaedica 84(5):502–505

    Article  PubMed Central  PubMed  Google Scholar 

  30. Topouchian V, Mazda K, Hamze B, Laredo JD, Pennecot GF (2004) Aneurysmal bone cysts in children: complications of fibrosing agent injection. Radiology 232(2):522–526

    Article  PubMed  Google Scholar 

  31. Peraud A, Drake JM, Armstrong D, Hedden D, Babyn P, Wilson G (2004) Fatal ethibloc embolization of vertebrobasilar system following percutaneous injection into aneurysmal bone cyst of the second cervical vertebra. Am J Neuroradiol 25(6):1116–1120

    CAS  PubMed  Google Scholar 

  32. Rossi G, Rimondi E, Bartalena T, Gerardi A, Alberghini M, Staals EL, Errani C, Bianchi G, Toscano A, Mercuri M, Vanel D (2010) Selective arterial embolization of 36 aneurysmal bone cysts of the skeletal. Radiology 39:161–167

    Google Scholar 

  33. Mavrogenis AF, Angelini A, Rossi G, Rimondi E, Guerra G, Ruggieri P (2014) Successful NBCA embolization od a T2 aneurysmal bone cyst. Acta Orthop Belg 80:126–131

    PubMed  Google Scholar 

  34. Rossi G, Mavrogenis AF, Papagelopoulos PJ, Rimondi E, Ruggieri P (2012) Successful treatment of aggressive aneurysmal bone cyst of the pelvis with serial embolization. Orthopedics 35(6):e963–e968

    Article  PubMed  Google Scholar 

  35. Sirveaux F, Roche O, Huttin P, Rios M, Blum A, Molé D, Oncolor R (2004) Distal fibula reconstruction using a frozen allograft: a case report. Rev Chir Orthop Reparatice Appar Mot 90:581–585

    Article  CAS  Google Scholar 

  36. Immenkamp M, Ehrenbrink H, Knoche U (1982) Subperiosteal segmental resection and insertion of a fibular graft in the treatment of solitary bone cysts of the humerus. Arch Orthop Traum Surg 100(2):107–114

    Article  CAS  Google Scholar 

  37. Grzegorzewski A, Pogonowicz E, Sibinski M, Marciniak M, Synder M (2010) Treatment of benign lesions of humerus with resection and non-vascularised autogenous fibular graft. Int Orthop 34:1267–1272

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Conflict of interest

No benefits of any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Author information

Authors and Affiliations

  1. Orthopedic Oncology Unit, Department of Orthopedic Surgery, Mansoura University Hospital, 36 Al-Gomhoria Street, P.O. Box 35516, Mansoura, Egypt

    Mohamed F. Mostafa

Authors
  1. Mohamed F. Mostafa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohamed F. Mostafa.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mostafa, M.F. Subperiosteal resection of fibular aneurysmal bone cyst. Eur J Orthop Surg Traumatol 25, 443–450 (2015). https://doi.org/10.1007/s00590-014-1527-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00590-014-1527-8

Keywords

Search

Navigation