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ORIGINAL ARTICLE
Year : 2016  |  Volume : 51  |  Issue : 2  |  Page : 143-146

Fibular graft for reconstruction of proximal femoral aneurysmal bone cysts


Department of Orthopedic Surgery, Faculty of Medicine, Zagazig University, Zagazig, Egypt

Correspondence Address:
Adel M Salama
El-Zohor Square, Zagazig, Sharqia Governorate
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-1148.203148

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Background The treatment options of aneurysmal bone cyst might change according to patient’s age, location, and type of lesion. Curettage and insertion of bone graft or polymethyl methacrylate are the principal techniques used. Patients and methods Eight patients (five male and three female; aged 8–14 years, with a mean age of 11 years) were treated with fibular autograft and iliac graft for the treatment of aneurysmal bone cyst in the proximal femur. Plain radiography and clinical assessment were performed through the whole follow-up period between 20 and 48 months (with a mean of 36 months). The musculoskeletal tumor society scoring system for limb salvage for the lower limb was used for clinical evaluation. Results Clinically, seven out of eight patients had excellent results according to the musculoskeletal tumor society scoring system for limb salvage for the lower limb. One case had postoperative pathological fracture after beginning weight bearing. Fibular grafts were fully incorporated into the recipient site within 12–16 months, with a mean incorporation time of 13 months. The graft donor site showed some minor problems such as leg discomfort and heel pain. Conclusion Curettage and an autogenous nonvascularized fibular graft is a good technique to treat benign cystic lesions of the proximal femur in relatively young patients. It is recommended to externally protect the limb with plaster of Paris. Hydrogen peroxide lavage was used to control local recurrence.


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