Implantation of human demineralized bone matrix (DBM) for the treatment of juvenile bone cysts

Operative Orthopädie und Traumatologie
Hans-Jürgen HassWinfried Wagemann

Abstract

Definitive bony consolidation in juvenile bone cysts. Prevention of pathologic fractures. Preservation of limb function. Juvenile bone cysts at all sites. Malignant cystic lesions. After opening and curettage, the cyst is packed with human demineralized bone matrix (DBM). Clinical and radiologic checks after 1, 4, and 6 months, followed by further 6-monthly checks. Over a period of 2 years, nine cysts packed with DBM showed almost totally osteodense images after an average of 8 months, with no other significant changes (follow-up period: 24 months). A typical decrease in cyst transparency on the plain radiographs was already detectable in all patients after 3-4 months. Marked cortical remodeling was visible after 6 months. A significant complication in one cyst in the distal tibial region was a pathologic fracture following distortion trauma; this occurred after 5 months, probably because of insufficient filling of the cyst. The fractured limb was immobilized in a lower-leg cast and healed sufficiently for stable weight bearing after 12 weeks.

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