Study of the efficacy of the elastic intramedullary nails in the treatment of primary aneurysmal bone cysts in extremities

Background: The main treatment method of the primary aneurysmal bone cyst (ABC) in extremities is to curettage and bone grafts with high-speed burring, radiotherapy, sclerotherapy, arterial embolism and hormone therapy can be used for the lesions whose location cannot be easily exposed by the surgery. Regardless of the method, high recurrence rates are a common problem. Purpose To explore and compare the effect and efficacy of the elastic intramedullary nails in the treatment of primary ABC in extremities. Method 26 patients with primary ABC admitted and treated from 2010 to 2016 were studied retrospectively. 26 patients were divided into 2 groups according to the treatment plan: the patients of the control group received curettage and bone grafts with high-speed burring; the patients of the study group received curettage and bone grafts with high-speed burring + elastic intramedullary nail (ESIN). According to the imaging results (Neer grading) and MSTS(musculoskeletal tumor society)functional evaluation, the curative effect of the children of the 2 groups were analyzed statistically. Results A total of 10 patients of the control group received curettage and bone grafts with high-speed burring and a total of 16 patients of the study group received curettage and bone grafts with high-speed burring + ESIN. All of the patients were followed up for more than 2 years. 9 of the 26 patients recurred. According to the imaging results and MSTS function evaluation, there was statistically significant difference in the curative effect between the 2 groups ( P < 0.05).The recurrence cases in the study group have a better MSTS functioncal recovery. Conclusion Curettage and bone grafts with high-speed burring + ESIN can significantly reduce the recurrence rate of primary ABC in extremities. The using of ESIN has a good curative effect and efficacy.