- 期刊
Unicameral Bone Cyst: The Results of Methylprednisolone Acetate Injection versus Curettage and Bone Grafting
單腔骨囊腫－類固醇注射與刮除併骨移植之治療結果比較
並列摘要
To evaluate the clinical outcomes of local methylprednisolone acetate (MPA) injections versus surgical curettage and/or bone grafting for the treatment of unicameral bone cysts (UBC) in the National Taiwan University Hospital (NTUH). We attempted to find the prognostic factors for choosing the most suitable treatment in a given condition. Nineteen cases of UBC, 12 of them diagnosed by histological analysis and the other seven by clinical findings, were investigated. Information on sex, age, tumor location, treatment procedures, and outcomes was obtained from patient medical records. The data from imaging studies, laboratory tests, and specimen histopathology also was considered. The study involved 12 males and 7 females with an average age of 19 years (range: 3-49 years). The most common sites of UBC were the humerus (10/19 patients, 52.6%), and the femur (4/19 patients, 21%). MPA injection was performed in nine patients, surgical curettage and/or bone grafting was done in 15 cases, and five patients received both MPA injection and surgical curettage. The success rate was 66.7% (6/9patients) for the MPA injection and 86.7% (13/15) for surgical curettage and/or bone grafting. Recurrence rate after MPA injection was 33.3% (3/9 patients) with an average disease-free interval of 10 months. In contrast, recurrence after surgical curettage and/or bone grafting was 13.1% (2/15 patients) with an average disease-free interval of 13 months. An average of 2.5 MPA injections was necessary for the cystic lesions to heal. MPA injections and surgical curettage and/or bone grafting resulted in success rates of 66.7% and 86.7%, respectively. The time to union after local methylprednisolone injection is longer than that after surgical curettage and bone grafting. Larger UBC and those located in the lower extremities tended to unite more slowly. Given these results, we recommend surgical curettage and bone grafting in the lower extremities because the faster union rate reduces the risks of pathological fractures in the weight-bearing extremities.
延伸閱讀
- Lin, H. T., Tan, C. A., Cheng, C. W., Leung, L. F., Wang, P. C., Shen, P. W., Chen, Y. H., & Tan, C. A. (2006). 骨髓腔擴鑽與否在互鎖式髓內釘治療閉鎖性不穩定腔骨幹骨折之比較. 輔仁醫學期刊, 4(4), 167-176. https://www.airitilibrary.com/Article/Detail?DocID=18102093-200612-4-4-167-176-a
- Chen, W. M., Huang, C. K., Chaing, C. C., & Chen, T. H. (2004). 惡性骨腫瘤骨內段狀切除後以異體骨移植或體外高劑量放射線照射自體骨重建之臨床經驗. Journal of Orthopaedic Surgery Taiwan, 21(1), 1-7. https://www.airitilibrary.com/Article/Detail?DocID=10116923-200403-21-1-1-7-a
- 吳禕凡、楊明祥、張佩穎、張加明、陳遠謙（2011）。以血管栓塞、刮除及骨移植治療下顫骨動脈瘤性骨囊腫之病例報告。臺灣口腔顎面外科學會雜誌，22(4)，294-304。https://doi.org/10.7104/TJOMS.201112.0049
- Hsu, C. J., Chen, C. K. H., Wong, C. Y., & Yeh, L. R. (1996). 類固醇注射治療單腔骨性囊腫：病例報告. 中華放射線醫學雜誌, 21(1), 69-72. https://www.airitilibrary.com/Article/Detail?DocID=10188940-199602-21-1-69-72-a
- Chiang, T. E., Huang, Z. Y., Lin, C. K., Shieh, Y. S., Wang, Y. B., & Chen, Y. W. (2015). 以改良式骨劈術應用於移除顎骨囊腫－病例報告. 中華民國家庭牙醫學雜誌, 10(2), 17-22. https://doi.org/10.6566/JFD/2015.10(2).17