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| UDK 616.71-089-053.2" |
ISSN 035-2899, 37(2012) No 2 p.88-93 |
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Original paper The Most Frequent Tumour-like Lesions and Fibrous Osseous Defects in Childhood (Najčešći tipovi lezija sličnih tumorima i fibroznih defekata kosti u dečijem dobu) Vesna Nikolić (1), Slobodan Stanković (1), Duško Spasovski (1,2), Zoran Vukašinović (1,2), Zorica Živković (3,4) (1) INSTITUT ZA ORTOPEDSKO-HIRURŠKE BOLESTI “BANJICA”, BEOGRAD, (2) MEDICINSKI FAKULTET, UNIVERZITET U BEOGRADU, (3) KBC “DR DRAGIŠA MIŠOVIĆ”, BEOGRAD, (4) MEDICINSKA AKADEMIJA – US MEDICAL SCHOOL, EVROPSKI UNIVERZITET, BEOGRAD |
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| Summary: INTRODUCTION: The most frequent lesions in childhood are tumour-like lesions (solitary and aneurismal bone cyst) and fibrous osseous defects: fibrous dysplasia and nonossifying fibroma. They are most often diagnosed accidentally or following a pathological fracture, and treatment options include observation, non-operative and most commonly operative methods. Operative treatment modality depends on various factors, and is associated with a risk for serious complications: graft noninegration, recurrence of the lesion, infection and others. AIM: To determine the incidence of tumour- like lesions and fibrous osseous defects in childhood and to analyze the types and kinds of bone grafts applied in the surgical treatment. Material and methods: This research included a group of 57 paediatric patients (mean age 11 years 4 months), surgically treated at the Institute for Orthopaedic Surgery “Banjica” Belgrade. RESULTS: 11 patients (19.28%) were treated by autologous grafting, 41 patients by alografting (71.92%) and five patients using artificial graft-collagen bone matrix. Patients with solitary bone cyst had a significantly higher occurrence of pathological fracture (42.1%) than other patients (χ2 = 9.52, p<0,01). The final result was excellent, without recidive and with radiological findings of asymptomatic residual lesion in 11 cases (19.29%). CONCLUSION: We suggest the therapeutic protocol with isolated osteoplasty only for smaller fibrous bone defects and simple bone cysts, while other lesions require bone transplantation, with mandatory addition of adjuvant therapy in the case of aneurismal bone cyst. Pathological fractures should be treated non-operatively, followed by a subsequent osteoplasty. Autologous bony grafts are generally preferred graft type, while bone substituents are reserved for smaller lesions without pathological fracture. Napomena:
kompletan tekst rada na srpskom jeziku |
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Corresponding Address: Vesna Nikolić Mileve Ajnštajn 36, 11000 Beograd e-mail : kvalitet@iohbb.edu.rs |
Paper received: 21.8.2012 Paper accepted: 14. 9.2012 Paper Internet issues: 12.11.2012 |
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