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Salvage of Femoral Head in Aneurysmal Bone Cyst of the Neck of Femur Presenting with Pathological Fracture in Pregnancy: A Case Report

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Vol 32| Issue 2 | July – Dec 2019 | page: 46-49 | George M Srampickal, Mohamad Gouse, Subin Babu, Vinoo Mathew Cherian

Authors: George M Srampickal[1], Mohamad Gouse[1], Subin Babu[1], Vinoo Mathew Cherian[1]

[1]Department Of Orthopaedics, Christian Medical College, Vellore, Tamil Nadu, India.

Address of Correspondence
Dr. George M Srampickal,
Christian Medical College, Vellore, Tamil Nadu, India.
E-mail: drmsgeorge@gmail.com

Abstract

Salvage of femoral head following aneurysmal bone cysts (ABCs) of the neck of femur in pregnancy, presented with pathological fracture treated with a dual approach to the neck of femur, was not reported in the scientific literature. A 28-year-old lady at her 3rd month of gestation presented with pathological fracture through ABC of the neck of femur. The femoral head was salvaged successfully with single single-stage dual approach (anterior and lateral approach) extended curettage, allografting, and internal fixation. At two-2-year follow-up, her hip and function are preserved. This case highlights the advantages of a dual approach in salvage of femoral head in pathological fracture following destructive lesion of the neck of femur.
Keywords: Aneurysmal bone cysts, Pathological fracture, Femoral neck, Tumor in pregnancy, Femoral head salvage.

References

1. MintzMC, DalinkaMK, SchmidtR. Aneurysmal bone cyst arising in fibrous dysplasia during pregnancy.Radiology1987;165:549-50.
2. ElkattahR, FoulkB. A suspected pelvic aneurysmal bone cyst in pregnancy.Case Rep ObstetGynecol2013;2013:676087.
3. McQueenMM, ChalmersJ, SmithGD. Spontaneous healing of aneurysmal bone cysts. A report of two cases.J Bone Joint Surg Br1985;67:310-2.
4. ClarkeHD, DamronTA, SimFH. Head and neck replacement endoprosthesis for pathologic proximal femoral lesions.ClinOrthopRelat Res1998;???:210-7.
5. JaffeHL, LichtensteinL. Solitary unicameral bone cyst: With emphasis on the roentgen picture, the pathologic appearance and the pathogenesis.Arch Surg1942;44:1004-25.

6. LeithnerA, WindhagerR, LangS, HaasOA, KainbergerF, KotzR. Aneurysmal bone cyst. A population based epidemiologic study and literature review.ClinOrthopRelat Res1999:176-9.
7. DabskaM, BuraczewskiJ. Aneurysmal bone cyst. Pathology, clinical course and radiologic appearances.Cancer1969;23:371-89.
8. CottalordaJ, KohlerR, Salesde Gauzy J, ChotelF, MazdaK, LefortG, et al. Epidemiology of aneurysmal bone cyst in children: A multicenter study and literature review.J PediatrOrthop B2004;13:389-94.
9. ACOGCommittee on Obstetric Practice. ACOG Committee Opinion. Number 299, September 2004 (replaces No. 158, September 1995). Guidelines for diagnostic imaging during pregnancy.ObstetGynecol2004;104:647-51.

10. McColloughCH, SchuelerBA, AtwellTD, BraunNN, RegnerDM, BrownDL, et al.Radiation exposure and pregnancy: When should we be concerned?Radiographics2007;27:909-17.
11. LindeF, AndersenE, HvassI, MadsenF, PallesenR. Avascular femoral head necrosis following fracture fixation.Injury1986;17:159-63.
12. WaiEK, DavisAM, GriffinA, BellRS, WunderJS. Pathologic fractures of the proximal femur secondary to benign bone tumors.ClinOrthopRelat Res2001:279-86.
13. ShihHN, ChengCY, ChenYJ, HuangTJ, HsuRW. Treatment of the femoral neck amd trochanteric benign lesions.ClinOrthopRelat Res1996;:220-6.
14. XuJ, ZhangCQ. Salvage of a hip following pathological fracture through a large aneurysmal bone cyst: A case report.Hip Int2009;19:148-50.

How to Cite this Article: Srampickal G M, Gouse M, Babu S, Cherian V M | Salvage of Femoral Head in Aneurysmal Bone Cyst of the Neck of Femur Presenting with Pathological Fracture in Pregnancy:A Case Report | Kerala Journal of Orthopaedics | July – Dec 2019; 32(2): 46-49.

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Functional and Radiological Outcome of Non-operative Management of Simple Bone Cyst of Humerus Presenting with Pathological Fracture

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Vol 32| Issue 1 | Jan – June 2019 | page: 17-22 | Dominic Puthoor, Dijoe Davis, Shafeeq Muhammed Abubekkar

Authors: Dominic Puthoor [1], Dijoe Davis [1], Shafeeq Muhammed Abubekkar [1]

[1] Department Of Orthopaedics, Amala Institute Of Medical Sciences, Thrissur, Kerala, India

Address of Correspondence

Dr. Dominic Puthoor,
Orthopaedic Oncologist, Amala Institute Of Medical Sciences, Thrissur, Kerala, India.
E-mail: dkputhur@gmail.com

Abstract

Simple bone cyst (SBC) is a tumor-like lesion affecting bone. Humerus is the most common site of SBC. Most of the cases of SBC in humerus presents with a pathological fracture. In our study, patients presenting with pathological fracture of SBC in humerus were treated with intracystic injection of Depo-Medrol (methylprednisolone acetate) under computed tomography guidance followed by immobilization in U-slab for 1 month. Clinical and radiological assessment was done during follow-up. It is found that the patients promptly regain excellent function though radiologically healing of the lesion is only partial.
Keywords: Simple bone cyst, Tumor-like lesion, Pathological fracture.

References

1. Puthoor D, Davis D. Tumour-like lesions are we over treating them? J Bone Soft Tissue Tumors 2016;2:13-8.
2. Dominic KP, Dijoe D, Manathara LT. Tumour like lesions and their management: A retrospective study. Int J Res Orthop 2018;4:159-65.
3. Puthur DK. Tumour like lesions: Understand the difference. Kerala J Orthop 2013;26:137-41.
4. Christopher F, Bridge JA, Hogendoorn PC, Fredrik M. WHO Classificatiaon of Soft Tissue and Bone. 4th ed. ???: ???; 2013. p. 240-1, 301.
5. Schajowicz F. Histological Typing of Bone Tumours. World Health Organization; International Histological Classification of Tumours. 2nd ed. Geneva: World Health Organization; 1993. p. 36-42.
6. Lokiec F, Wientroub S. Simple bone cyst: Etiology, classification, pathology, and treatment modalities. J PediatrOrthop B 1998;7:262-73.
7. Kadhim M, Sethi S, Thacker MM. Unicameral bone cysts in the humerus: Treatment outcomes. J PediatrOrthop 2016;36:392-9.
8. Chang CH, Stanton RP, Glutting J. Unicameral bone cysts treated by injection of bone marrow or methylprednisolone. J Bone Joint Surg Br 2002;84:407-12.
9. Cho HS, Oh JH, Kim HS, Kang HG, Lee SH. Unicameral bone cysts. Bone Joint J 2007;89:222-6.
10. Nelson BL. Solitary bone cyst. Head Neck Pathol 2010;4:208-9.
11. Kim MC, Joo SD, Jung ST. The role of fractures on pathologic bone in healing of proximal humerus unicameral bone cysts. J Orthop Surg (Hong Kong) 2018;26:2309499018778366.
12. Enneking WF. Modification of the System for Functional Evaluation in the Surgical Management of Musculoskeletal Tumors. Limb Salvage in Musculoskeletal Oncology. New York: Churchill Livingstone; 1987.
13. Horstmann PF, Hettwer WH, Petersen MM. Treatment of benign and borderline bone tumors with combined curettage and bone defect reconstruction. J Orthop Surg (Hong Kong) 2018;26:1-7.
14. Liu PT, Valadez SD, Chivers FS, Roberts CC, Beauchamp CP. Anatomically based guidelines for core needle biopsy of bone tumors: Implications for limb-sparing surgery. Radiographics 2007;27:189-205.
15. Espinosa LA, Jamadar DA, Jacobson JA, DeMaeseneer MO, Ebrahim FS, Sabb BJ, et al. CT-guided biopsy of bone: A radiologist’s perspective. AJR Am J Roentgenol 2008;190:W283-9.
16. Campanacci MD, Enneking WF. Simple bone cyst. In: Text Book Bone Soft Tissue Tumors. ???: ???; ???.
17. Campanacci M, De Sessa L, Trentani C. Scaglietti’s method for conservative treatment of simple bone cysts with local injections of methylprednisolone acetate. Ital J OrthopTraumatol 1977;3:27-36.
18. Cohen J. Etiology of simple bone cyst. J Bone Joint Surg Am 1970;52:1493-7.
19. Shindell R, Huurman WW, Lippiello L, Connolly JF. Prostaglandin levels in unicameral bone cysts treated by intralesional steroid injection. J PediatrOrthop 1989;9:516-9.

How to Cite this Article: Puthoor D, Davis D, Abubekkar S M. Functional and Radiological Outcome of Non-operative Management of Simple Bone Cyst of Humerus Presenting with Pathological Fracture. Kerala Journal of Orthopaedics Jan-June 2019; 32(1): 17-22 .

(Abstract)      (Full Text HTML)   (Download PDF)