背景:动脉瘤性骨囊肿(ABCs)是溶骨性的,非恶性,骨的血管病变。病理性骨折可能是ABCs的表现,发生在约8%的ABC中。文献中已经描述了不同的治疗方法,但是,如今,ABCs患者病理性骨折的最佳治疗仍存在争议,目前尚无标准的治疗指南,也没有关于最佳手术干预的共同指征.我们研究的目的是回顾有关此问题的现有文献,探索和面对ABC中病理性骨折的不同手术治疗方法,以阐明这些患者的手术方法。方法:对PubMed索引的文献进行系统回顾,MEDLINE,并进行了Cochrane图书馆数据库。遵循系统审查和荟萃分析(PRISMA)的首选报告项目。结果:共有37篇相关文章最终纳入研究。总的来说,我们达到了140名患者。在纳入审查的140名患者中,124例患者(88.6%)接受了刮宫手术,15例(10.7%)患者行整块切除手术。共有47%的患者(70)接受了钢板的综合手术,螺钉,钉,或外固定器。8.6%的患者使用辅助治疗(12)。并发症涉及20.7%的患者(29)。结论:总之,动脉瘤性骨囊肿病理性骨折的治疗需要仔细的患者评估,考虑到年龄等因素,开放生长板的存在,病变的位置,和外科医生的专业知识。
Background: Aneurysmal bone cysts (ABCs) are osteolytic, non-malignant, vascular lesions of the bone. Pathological fractures can be a manifestation of the ABCs, which occur in about 8% of ABCs. Different treatments have been described in the literature, but, nowadays, an optimal management of the pathological fractures in patients with ABCs is still a matter of debate and there are no standard guidelines for treatment nor any shared indication about the best surgical intervention. The aim of our study is to review the current literature available on this matter exploring and confronting different surgical treatments for pathological fractures in ABC in order to clarify the surgical approach to these patients. Methods: A systematic review of the literature indexed in PubMed, MEDLINE, and Cochrane Library databases was carried out. The Preferred Reporting Items for Systematically Reviews and Meta-Analyses (PRISMA) were followed. Results: A total of 37 articles were relevant and were finally included in the study. In total, we reached a population of 140 patients. Of the 140 patients included in the review, 124 patients (88.6%) underwent curettage surgery, 15 patients (10.7%) underwent en bloc resection surgery. A total of 47% of patients (70) underwent synthesis surgery with a plate, screw, nail, or external fixator. Adjuvant treatments were used in 8.6% of patients (12). Complications involved 20.7% of the patients (29). Conclusions: In conclusion, the treatment of pathological fractures in aneurysmal bone cysts requires careful patient assessment, considering factors such as age, the presence of open growth plates, the location of the lesion, and the surgeon\'s expertise.