Interventions for treating simple bone cysts in the long bones of children.
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ABSTRACT:
SUBMITTER: Zhao JG
PROVIDER: S-EPMC6464391 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundSimple bone cysts (SBCs) are common osteolytic lesions in children, which often lead to pathological fractures of the non-weight-bearing bone (humerus) in patients. Cyst index is a classic index to evaluate the risk of pathological fracture, but the reliability of this index is reduced due to the deviation of cyst area in the frontal and lateral position and the subjectivity of the determination of cyst area. MRI can clearly show the cyst boundary, the appointment cycle is long, and children need to be examined under sedation, which cannot be judged by clinicians in time. Therefore, it is necessary to find a basic and simple imaging evaluation index in clinic. The purpose of this study is to retrospectively analyze the risk factors of pathological fracture of simple bone cyst of humerus in children.MethodsThe medical records and plain films of patients with SBCs from January 2014 to December 2021 were retrospectively analyzed. Patients were divided into a fracture group (35 cases) and a non-fracture group (10 cases). The relationship between pathological fractures and the children's age, gender, and cyst index was analyzed. The presence of the pectoralis major and the link to the tendon insertion site of ectopectoralis and anconeus lateralis (TEAL) of the lesion were also examined. Perform binary logistic regression analysis.ResultsBinary logistic regression analysis was performed on the age, gender, and cyst index, and whether the lesion was located in the TEAL. The results demonstrated that the TEAL was an independent risk factor for fractures [odds ratio (OR) =21.423, 95% confidence interval (CI): 2.409-190.539; P=0.006].ConclusionsSBCs of humerus in children is often accompanied by pathological fracture. The lesion is located at TEAL, so we should be alert to the risk of pathological fracture.
| S-EPMC9360809 | biostudies-literature
Project description: Not available
| S-EPMC6516962 | biostudies-literature
Project description:Bone microstructure reflects physiological characteristics and has been shown to contain phylogenetic and ecological signals. Although mammalian long bone histology is receiving increasing attention, systematic examination of the main clades has not yet been performed. Here we describe the long bone microstructure of Xenarthra based on thin sections representing twenty-two species. Additionally, patterns in bone compactness of humeri and femora are investigated. The primary bone tissue of xenarthran long bones is composed of a mixture of woven, parallel-fibered and lamellar bone. The vascular canals have a longitudinal, reticular or radial orientation and are mostly arranged in an irregular manner. Concentric rows of vascular canals and laminar organization of the tissue are only found in anteater bones. The long bones of adult specimens are marked by dense Haversian bone, a feature that has been noted for most groups of mammals. In the long bones of armadillos, secondary osteons have an oblique orientation within the three-dimensional bone tissue, thus resulting in their irregular shape when the bones are sectioned transversely. Secondary remodeling is generally more extensive in large taxa than in small taxa, and this could be caused by increased loading. Lines of arrested growth are assumed to be present in all specimens, but they are restricted to the outermost layer in bones of armadillos and are often masked by secondary remodeling in large taxa. Parameters of bone compactness show a pattern in the femur that separates Cingulata and Pilosa (Folivora and Vermilingua), with cingulates having a lower compactness than pilosans. In addition, cingulates show an allometric relationship between humeral and femoral bone compactness.
| S-EPMC3706384 | biostudies-literature
Project description: Not available
| S-EPMC9178297 | biostudies-literature
Project description:BACKGROUND:The healing of long bones diaphyseal fractures can be often impaired and eventually end into delayed union and non-union. A number of therapeutic strategies have been proposed in combination with surgical treatment in order to enhance the healing process, such as scaffolds, growth factors, cell therapies and systemic pharmacological treatments. Our aim was to investigate the current evidence of bone healing enhancement of acute long bone diaphyseal fractures. METHODS:A systematic review was conducted by using Pubmed/MEDLINE; Embase and Ovid databases. The combination of the search terms "long-bones; diaphyseal fracture; bone healing; growth factors; cell therapies; scaffolds; graft; bone substitutes; orthobiologics; teriparatide". RESULTS:The initial search resulted in 4156 articles of which 37 papers fulfilled the inclusion criteria and were the subject of this review. The studies included 1350 patients (837 males and 513 females) with a mean age of 65.3 years old. CONCLUSIONS:General lack of high-quality studies exists on the use of adjuvant strategies for bone healing enhancement in acute shaft fractures. Strong evidence supports the use of bone grafts, while only moderate evidence demineralized bone matrix and synthetic ceramics. Conflicting results partially supported the use of growth factors and cell therapies in acute fractures. Teriparatide showed promising results, particularly for atypical femoral fractures and periprosthetic femoral fractures.
| S-EPMC7148449 | biostudies-literature
Project description:ObjectiveTo retrospectively analyze the biological compatibility and oncologic outcomes of autogenous, allogeneic, or combined bone grafting.MethodsFrom April 2000 to December 2016, 37 patients with histologically confirmed low-grade intramedullary chondrosarcoma of the long bones at Kyungpook National University Hospital were enrolled in this retrospective study. All 37 patients underwent intralesional curettage (with or without cryotherapy) followed by bone grafting. Among the 24 patients who underwent cryotherapy, 13 were treated by prophylactic internal fixation (10 in the femur, 1 in the tibia, and 2 in the humerus). Thirteen patients underwent the same treatment without cryotherapy, whereas 12 did not undergo preventive internal fixation.ResultsA single intraoperative fracture was managed by plate fixation. One patient who underwent cryotherapy and internal fixation developed a fracture distal to the operation site 25 days after surgery, and this fracture was repaired with a long plate. None of the 37 patients showed any recurrence or metastasis.ConclusionsAdequate intralesional curettage (with or without cryosurgery) combined with bone grafting using autogenous and allogeneic bone chips was effective for the treatment of low-grade intramedullary chondrosarcoma. Therefore, prophylactic internal fixation using a plate is recommended in the cryotherapy of definite cortical invasion in weight-bearing bones.
| S-EPMC8320587 | biostudies-literature
Project description:BackgroundWe conducted a multi-center study to investigate the prevalence, the malignant transformation potential of the simple renal cysts and the factors that might predict malignancy.MethodsWe defined the simple renal cysts as Bosniak class I & II (including IIF) lesions. In the prevalence study, data from 115,132 ultrasonographies was collected from individuals who participated in a multiphasic health wellness screen. In the natural history and progression study, we retrospectively reviewed 333 participants with simple renal cysts and were followed for at the least 3 years with a mean of 6.3±2.9 years (ranged from 3 to 13 years).ResultsAbout 7.2% (8,303) of the individuals who participated in the study were found to have at the least one simple renal cyst. The incidence increased with age from 0.6% in the first decade to 28.0% in the eighth or later decade of life. The Bosniak class I lesion accounted for 7,559 or 91.0% of the cysts whereas 744 or 9.0% were class II. A slower growth rate was observed in the older age group. Twenty-four patients (7.2%) had their renal cysts upgraded according to the Bosniak classification. Gender, age, initial cyst size, number of cysts and bi-laterality failed to predict the malignancy tendency.ConclusionsMost of the cysts discovered were the Bosniak class I and II lesions and they rarely progress further. Treatment for the asymptomatic simple renal cyst is not warranted. Treatment decision-making based on older age or larger initial cyst size should not be recommended.
| S-EPMC7215042 | biostudies-literature
Project description: Not available
| S-EPMC6521597 | biostudies-literature
Project description:Simple (Bosniak I) renal cysts are considered acceptable in living kidney donor selection in terms of cancer risk. However, they tend to increase in number and size over time and might compromise renal function in donors. To clarify their implications for long-term renal function, we characterized the prevalence of renal cysts in 454 individuals who donated at our center from 2000 to 2007. We estimated the association between the presence of cysts in the kidney remaining after nephrectomy (ie, retained cysts) and postdonation eGFR trajectory using mixed-effects linear regression. Donors with retained cysts (N = 86) were older (P < .001) and had slightly lower predonation eGFR (median 94 vs 98 mL/min/1.73 m2 , P < .01) than those without cysts. Over a median 7.8 years, donors with retained cysts had lower baseline eGFR (-8.7 -5.6 -2.3 mL/min/1.73 m2 , P < .01) but similar yearly change in eGFR (-0.4 0.02 0.4 mL/min/1.73 m2 , P = .2) compared to those without retained cysts. Adjusting for predonation characteristics, there was no difference in baseline eGFR (P = .6) or yearly change in eGFR (P > .9). There continued to be no evidence of an association when we considered retained cyst(s) ≥10 mm or multiple retained cysts (all P > .05). These findings reaffirm current practices of accepting candidates with simple renal cysts for donor nephrectomy.
| S-EPMC8720490 | biostudies-literature
Project description:Bone generally displays a high intrinsic capacity to regenerate. Nonetheless, large osseous defects sometimes fail to heal. The treatment of such large segmental defects still represents a considerable clinical challenge. The regeneration of large bone defects often proves difficult, since it relies on the formation of large amounts of bone within an environment impedimental to osteogenesis, characterized by soft tissue damage and hampered vascularization. Consequently, research efforts have concentrated on tissue engineering and regenerative medical strategies to resolve this multifaceted challenge. In this review, we summarize, critically evaluate, and discuss present approaches in light of their clinical relevance; we also present future advanced techniques for bone tissue engineering, outlining the steps to realize for their translation from bench to bedside. The discussion includes the physiology of bone healing, requirements and properties of natural and synthetic biomaterials for bone reconstruction, their use in conjunction with cellular components and suitable growth factors, and strategies to improve vascularization and the translation of these regenerative concepts to in vivo applications. We conclude that the ideal all-purpose material for scaffold-guided bone regeneration is currently not available. It seems that a variety of different solutions will be employed, according to the clinical treatment necessary.
| S-EPMC9953456 | biostudies-literature