Results of Allografts and Synthetic Grafts in Humeral Simple Bone Cysts.

PURPOSE OF THE STUDY: Simple bone cysts (SBCs) are the most common benign bone lesions in childhood. There are many different methods in the treatment of SBCs. There is no consensus on which method to use in the treatment. In this study, we compared the results of allogeneic bone graft or synthetic bone graft in addition to fl exible intramedullary nail (FIN) for SBC located in the humerus. MATERIAL AND METHODS: This retrospective study comparing the data of 19 (group 1: 8 curettage, allograft and FIN; group 2: 11 curettage, synthetic graft and FIN) patients with a mean age of 11.4 (6 to 26; seven female, twelve male) who were surgically treated in our hospital for humeral SBC between April 2014 and January 2020. Patient data included age, sex, anatomical side, stage of the cyst, pathological fracture, previous treatments and complications. RESULTS: The mean follow-up period was 33.7 months (12 to 61). The average last follow-up Musculoskeletal Tumor Society functional scores for groups 1 and 2 were 27.8 (20 to 30) and 28.6 (21 to 30) (P > 0.05). Complete or signifi cant partial radiographic healing rates were achieved in group 1 (75%) compared with group 2 (81.9%). The reoperation rates for groups 1 and 2 were 62.5% (5/8; three for nails removed, two for recurrence) and 36.3% (4/11; two for nails removed, two for recurrence). One patient in group 2 had a 15° varus deformity due to recurrence. No other complications were observed. CONCLUSIONS: The combination of curettage-grafonage FIN is a common treatment method in recent years, as it provides early cyst healing and limb mobilization in SBCs located in the upper extremity. For defects after curettage of the bone cysts, allogeneic or synthetic grafts (granule b-tricalcium phospate) which have similar results in terms of healing can be used as an alternative to each other. KEY WORDS: allografts, bone cysts, bone nails, synthetic grafts, humerus.

Evaluation of surgical or conservative treatment of forearm fracture in pediatric floating elbow injuries.

OBJECTIVE: Floating elbow, which refers to a humerus fracture in the supracondylar region and a forearm fracture, is a very unusual injury. The purpose of this study is to compare the clinical results of patients with "floating elbows" who underwent surgical therapy and who were given forearm immobilization with a splint as follow-up care. PATIENTS AND METHODS: Fifteen patients who had been diagnosed with floating elbow owing to trauma were scanned retrospectively and followed up for at least a year. Eight individuals who suffered from broken forearms underwent surgical repair. After initial treatment, a lengthy arm splint was used to immobilize seven patients' arms. The modified Flynn criteria were used to analyze the data, and comparisons were made between the groups. RESULTS: The median age and mean follow-up time for patients whose forearms were conservatively followed was 6.1 years and 13.8 months, respectively. The median age of the patients who underwent forearm surgery was 8.5 years, and the average follow-up was 14.2 months. Five of the seven patients whose forearms underwent conservative follow-up had outstanding clinical outcomes, while two had poor and moderate outcomes. Four individuals who got surgical treatment for their forearms had excellent and good clinical outcomes, while the other four had intermediate and poor outcomes. Between the two groups, there was no discernible difference (p = 0.60). CONCLUSIONS: In the pediatric population with floating elbow injuries, using a cast for forearm fractures may not necessarily result in worse outcomes compared to surgical management.

The importance of low visfatin values in osteoid osteoma patient: a prospective study.

OBJECTIVE: Visfatin is currently a cytokine that is extensively researched in the field of bone diseases. In this prospective study, we aimed to investigate the potential of serum visfatin levels as a biomarker for the diagnosis of osteoid osteoma. PATIENTS AND METHODS: This study included a cohort of 20 patients diagnosed with osteoid osteoma (Group 1) and 30 healthy individuals (Group 2). The age, gender, cyst sizes, and visfatin values of all participants were documented and analyzed. RESULTS: There was a significant difference in visfatin levels between the two groups. The median visfatin level in Group 1 was 6.13 ng/ml (IQR: 4.21-8.08), while in Group 2, it was 15.83 ng/ml (IQR: 11.11-20.6). The difference was statistically significant (p<0.000). The optimal cut-off value for visfatin was found to be 7.74 ng/ml, which had a 93% sensitivity and 78% specificity.  An area under the curve of receiver operating characteristic (ROC) analysis of 0.85 indicates good diagnostic performance. CONCLUSIONS: Our study revealed a significant decrease in visfatin levels among patients diagnosed with osteoid osteomas in comparison to the healthy control group. The ROC analysis revealed that visfatin exhibited a commendable diagnostic capacity, indicating its potential utility as a biomarker for osteoid osteoma.