Abstract：
OBJECTIVE: The aim of this study was to evaluate and compare different surgical treatment modalities for simple bone cysts (SBC) of the humerus regarding their effectiveness and recurrence rate.
METHODS: In this retrospective study, patients who received surgical treatment for previously untreated primary SBCs of the humerus were analyzed. Demographic data, cyst-specific as well as treatment-specific parameters, complications, treatment failures, and recurrence rates were collected and correlated with different treatment modalities. Observed procedures were categorized as open procedure (n=20) or osteosynthesis alone (n=3). For the open procedure group, four subgroups could be defined.
RESULTS: Twenty-three patients were included. The mean age at diagnosis was 11.6 ± 2.5 years, and the mean postoperative follow-up was 3.9 ± 2.6 years (range 1.0-10.3). After surgical intervention, a total of five (21.7%) patients showed at least one recurrence. Fracture occurred in three (13.0%) cases. The incidence of treatment failure was significantly higher in the curettage, allograft, adjuvants group, with five (83.3%) of six cases showing recurrence, than in the other subgroups (≤ 25.0%) including the osteosynthesis alone group (p=.024). For the open procedure group, the failure-free survival rates were 80.0% after two years and 50.4% after five years. For the three cases treated by osteosynthesis alone, no failures were observed.
CONCLUSIONS: Open procedures showed similar failure rates except for the subgroup using curettage, allograft, and adjuvants which showed significantly higher treatment failure. Promising results were observed in the group which received solely osteosynthesis without cyst excision or filling, as no treatment failure was observed here.
METHODS: In this retrospective study, patients who received surgical treatment for previously untreated primary SBCs of the humerus were analyzed. Demographic data, cyst-specific as well as treatment-specific parameters, complications, treatment failures, and recurrence rates were collected and correlated with different treatment modalities. Observed procedures were categorized as open procedure (n=20) or osteosynthesis alone (n=3). For the open procedure group, four subgroups could be defined.
RESULTS: Twenty-three patients were included. The mean age at diagnosis was 11.6 ± 2.5 years, and the mean postoperative follow-up was 3.9 ± 2.6 years (range 1.0-10.3). After surgical intervention, a total of five (21.7%) patients showed at least one recurrence. Fracture occurred in three (13.0%) cases. The incidence of treatment failure was significantly higher in the curettage, allograft, adjuvants group, with five (83.3%) of six cases showing recurrence, than in the other subgroups (≤ 25.0%) including the osteosynthesis alone group (p=.024). For the open procedure group, the failure-free survival rates were 80.0% after two years and 50.4% after five years. For the three cases treated by osteosynthesis alone, no failures were observed.
CONCLUSIONS: Open procedures showed similar failure rates except for the subgroup using curettage, allograft, and adjuvants which showed significantly higher treatment failure. Promising results were observed in the group which received solely osteosynthesis without cyst excision or filling, as no treatment failure was observed here.
摘要：
目的：本研究的目的是评估和比较不同的手术方式治疗肱骨单纯性骨囊肿（SBC）的疗效和复发率。
方法：在这项回顾性研究中，我们分析了接受手术治疗的既往未治疗的原发性肱骨SBCs患者.人口统计数据,囊肿特异性和治疗特异性参数，并发症,治疗失败,收集复发率，并与不同的治疗方式相关。观察到的程序分为开放程序（n=20）或单独的骨合成（n=3）。对于打开的过程组，可以定义四个子组。
结果：纳入23例患者。诊断时的平均年龄为11.6±2.5岁，术后平均随访时间为3.9±2.6年（范围1.0-10.3）。手术干预后,共有5例(21.7%)患者出现至少1例复发.骨折3例（13.0%）。刮治失败的发生率明显较高，同种异体移植,佐剂组，6例中有5例(83.3%)复发,比其他亚组（≤25.0％），包括单独的骨合成组（p=.024）。对于打开的过程组，2年和5年后无失败生存率分别为80.0%和50.4%。对于仅通过骨合成术治疗的三例病例，没有观察到失败。
结论：开放手术显示类似的失败率，除了使用刮宫的亚组，同种异体移植,和显示明显更高的治疗失败的佐剂。在仅接受无囊肿切除或填充的骨接合术的组中观察到有希望的结果。因为这里没有观察到治疗失败。
方法：在这项回顾性研究中，我们分析了接受手术治疗的既往未治疗的原发性肱骨SBCs患者.人口统计数据,囊肿特异性和治疗特异性参数，并发症,治疗失败,收集复发率，并与不同的治疗方式相关。观察到的程序分为开放程序（n=20）或单独的骨合成（n=3）。对于打开的过程组，可以定义四个子组。
结果：纳入23例患者。诊断时的平均年龄为11.6±2.5岁，术后平均随访时间为3.9±2.6年（范围1.0-10.3）。手术干预后,共有5例(21.7%)患者出现至少1例复发.骨折3例（13.0%）。刮治失败的发生率明显较高，同种异体移植,佐剂组，6例中有5例(83.3%)复发,比其他亚组（≤25.0％），包括单独的骨合成组（p=.024）。对于打开的过程组，2年和5年后无失败生存率分别为80.0%和50.4%。对于仅通过骨合成术治疗的三例病例，没有观察到失败。
结论：开放手术显示类似的失败率，除了使用刮宫的亚组，同种异体移植,和显示明显更高的治疗失败的佐剂。在仅接受无囊肿切除或填充的骨接合术的组中观察到有希望的结果。因为这里没有观察到治疗失败。
