Outcomes of prophylactic intramedullary fixation for benign bone lesions

INTRODUCTION: In this study, we aimed to present the results of patients who underwent prophylactic intramedullary fixation for benign bone lesions.
METHODS: Twenty-two patients who underwent curettage, grafting and prophylactic intramedullary fixation for benign bone lesions between 2008 and 2017 were included in this study. The lesions were examined according to the Mirels’ classification in the preoperative period and the pathological fracture risk was determined. Curettage, allografting and intramedullary fixation were used in the treatment of all patients. In the follow-up examination, patients were evaluated according to the range of motion, pain, radiological appearance of the lesion and the implant.
RESULTS: The mean age of the patients was 24.8 (7-38) years. The mean follow-up period was 35.8 (13-80) months. The initial complaint of twenty-one patients was pain which caused loss of function in two patients. One patient with pathological humerus fracture was admitted with acute pain and loss of function. He was followed conservatively for two months, then prophylactic surgery was performed. The mean Mirels’ score of the patients was 9.3 (9-10). In the follow-up examination, the range of motion was full in all patients. The mean VAS score decreased from 8.09 to 2.54 postoperatively.
DISCUSSION AND CONCLUSION: We conclude that prophylactic fixation for benign bone lesions which has 9 or more Mirels’ score reduces the risk of impending pathological fractures, reduces VAS scores, and also prevents loss of function and enables to return normal activity earlier.

Ýyi huylu kemik lezyonlarýnda profilaktik intramedüller fiksasyon sonuçlarý

GÝRÝÞ ve AMAÇ: Bu çalýþmada benign kemik lezyonu sebebiyle profilaktik intramedüller tespit ameliyatý yaptýðýmýz hastalarýn sonuçlarýný sunmayý amaçladýk.
YÖNTEM ve GEREÇLER: Bu çalýþmaya 2008-2017 yýllarý arasýnda benign kemik lezyonu nedeni ile küretaj, greftleme ve profilaktik intramedüller tespit ameliyatý yaptýðýmýz 22 hasta dâhil edilmiþtir. Lezyonlar preoperatif dönemde Mirels sýnýflamasýna göre incelenerek patolojik kýrýk riski belirlenmiþtir. Tüm hastalarýn tedavisinde küretaj, greftleme ve intramedüller tespit yöntemi kullanýlmýþtýr. Kontrol muayenelerinde hastalar; eklem hareket açýklýklarýna, aðrý durumuna, lezyonun ve implantýn radyolojik görüntüsüne göre deðerlendirilmiþtir.
BULGULAR: Hastalarýn yaþ ortalamasý 24,8 (aralýk, 7-38) yýldý. Hastalar ortalama 35,8 (aralýk, 13-80) ay takip edildi. Çalýþmaya dâhil edilen 21 hastanýn ilk baþvuru nedeni aðrý olup 2 hastada aðrý fonksiyon kaybýna neden olmaktaydý. Patolojik humerus kýrýðý olan bir hasta akut aðrý ve fonksiyon kaybý ile baþvurdu, iki ay konservatif olarak takip edildi ve ardýndan profilaktik cerrahi yapýldý. Hastalarýn ortalama Mirels skoru 9,3 (aralýk, 9-10)’tü. Takiplerde tüm hastalarýn ekstremite fonksiyonlarý tamdý. Ameliyat sonrasý ortalama VAS 8,09'dan 2,54'e gerilemiþtir.
TARTIÞMA ve SONUÇ: 9 veya daha fazla Mirels skoruna sahip olan iyi huylu kemik lezyonlarý için profilaktik fiksasyonun, olasý patolojik kýrýk riskini azalttýðý, VAS skorlarýný azalttýðý, ayrýca fonksiyon kaybýný önlediði ve daha erken normal aktivitesine geri dönüþe olanak saðladýðý sonucuna vardýk.