Excision of the lesions is another treatment option for SBCs, but in recent years, less invasive treatments have become preferable thus, it is extremely rare for excision, Ilizarov fixation, and bone extension to be used in combination for the treatment of SBC. The combined use of Ilizarov fixation and bone extension is a treatment method often used for rebuilding in cases of infection, pseudarthrosis, and bone defects after removing bone tumors. Effective surgical treatments include: curettage curettage with bone grafting curettage with bone substitution curettage with myoplasty, reduced pressure, and shunt method intramedullary flexible nails and a combination of these. Steroid injections, autologous bone marrow injections, and demineralized bone matrix injections are used as conservative treatments. Several treatment options are available age, sex, level of activity, and location of the SBC play a role in selecting the most appropriate therapeutic approach. The purpose of treatment is primarily to prevent pathological fractures and to minimize limitations in daily activities. When adjacent to the epiphyseal plate, SBC is believed to be in the active phase, during which the disease is more active and more likely to recur, while in the latent phase, the SBC is separated from the epiphyseal plate. Thinning of the cortical bone increases the risk of pathological fractures, and pain caused by these fractures often drives the patient to seek medical care. SBC moves to the diaphysis as the patient grows and may heal without treatment. There are several reports on the potential etiologies of SBC, which include anomalous venous drainage, prostaglandin, interleukin-1, proteolytic enzymes, nitrogen monoxide involvement, and bone reabsorption instigated by parietal cells, but none have been confirmed.
In slightly older age groups, a large proportion of cases develop SBCs in the calcaneus these cases differ from SBCs occurring in the tubular bones. Frequent sites of development include long tubular bones, particularly the humerus and femur. We believe that our shortening-distraction method is effective for the treatment of severe deformity with unbalanced soft tissues.Ī simple bone cyst (SBC) is a tumor-like condition of the bone in which a cavity filled with serous fluid forms in the bone marrow, often during childhood and adolescence. To prevent increasing bone deformity and fragility, the deformity should be corrected as quickly as possible using intramedullary nailing or other fixation techniques. When a long bone is in a prolonged state of deformation, the deformity not only progresses as the bone grows, but the soft tissues remain unbalanced and treatment becomes increasingly difficult. At present, 3 years after surgery, the deformity has not recurred and our patient is living without any limitations in daily activities or regular exercise.
To correct this deformity, we excised the lesion, thus shortening the femur, then corrected the alignment and applied an Ilizarov fixator to extend the bone. The deformity included bowing of approximately 90° and an internal rotation of 60° in the middle third of the femoral shaft. Case presentationĪ 9-year, 7-month-old Japanese girl was referred to our facility with obvious deformity of her right femur, caused by multiple simple bone cyst-related pathological fractures. Finally, we propose a treatment option for malunion correction. Here we report a case of severe femoral deformity after multiple pathological fractures due to simple bone cysts, and consider the reason for the progression of malunion despite multiple previous treatments. Although a simple bone cyst carries the risk of pathological fractures, it rarely causes severe deformity.
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