Akademik Veri Yönetim Sistemi
12th Bapras Congress 2023, Konya, Türkiye, 13 - 16 Eylül 2023, ss.273-276
Introduction
Aneurysmal bone cysts
account for approximately 5% of benign bone tumors, but only 3% to 5% of all
aneurysmal bone cysts occur in the hand. Hand lesions most commonly occur in
the second decade of life, with males and females equally affected. Metacarpal
involvement is more common than phalangeal involvement, and carpal lesions are
rare.
A 6-year-old female
patient applied to our policlinic with swelling around the 1st metacarpal bone
of the right hand. Radiological imaging was consistent with an aneurysmal bone
cyst. Radiological diagnosis has been verified pathologically by open biopsy. The
decision to follow up has been made. However, a rapid enlargement had seen in
the 6th month and 1st year. Total excision had been decided because of the threat
to hand functions—reconstructive options and results were evaluated with
parents. The aneurysmal bone cyst was excised and reconstructed with a free
fibula flap. There were no complications in the postoperative follow-ups.
Discussion and
conclusion
Enchondroma,
periosteal enchondroma, osteochondroma, osteoid osteoma, chondromyxoid fibroma,
osteoblastoma, unicameral bone cyst, aneurysmal bone cyst, and giant cell tumor
of bone are the benign tumors of the upper extremity. Enchondroma is the most
common bone tumor of the hand, and %90 of Enchondromas are seen on the hand. For
most bone defects of less than 6 cm with a well-vascularized bed, adequate soft
tissue cover, and absence of infection, a conventional cancellous or cortico-cancellous
auto-graft is generally recommended. Cancellous bone has greater inductive
capacity than cortical bone and should be used unless mechanical stability is
required.
Unlike conventional
bone grafts, vascularized bone remains alive and dynamic in its new site.
Viable bone does not undergo creeping substitution; thus significant osteopenia
does not occur. The result is improved strength, healing, and stress
responsiveness compared with non-vascularized conventional bone grafts. The
incidence of stress fracture is lower than in massive structural auto-grafts or
allografts. Further, the bone union is more rapid, and bone hypertrophy in
response to applied stress may occur with time.
Since it is in the
pediatric age group, the thumb has great importance for hand function, and the lesion
is continuous throughout the entire metacarpal bone, we considered
reconstruction with a vascularized fibula flap.