Benign bone tumors

Surgical treatment of benign bone tumors

An intralesional procedure (curettage) is performed for benign bone tumors of all stages. However, for many stage-2 and all stage-3 benign bone tumors, the margins of excision within the lesion are extended by power curettage and adjuvant measures such as the use of phenol, methyl-methacrylate, or liquid nitrogen to increase the clearance margin.

After that the cavity can be packed with bone graft either autogenous, allograft or synthetic bone graft and in very young children below 8 years maternal bone graft can be used to fill the cavity as in those children there’s limited graft supply. Internal fixation according to the tumor size and location is used to add stability and alignment in some cases presented with pathological fracture.

Excision through the perilesional reactive zone (marginal margin) is indicated for benign non-infiltrating soft-tissue tumors, recurrent stage-2 or stage-3 benign bone tumors. Followed after that by reconstruction by various kinds of bone grafting, as what done after an intralesional procedure.

Wide margins are used for a few recurrent stage-3 benign bone tumors followed by reconstruction as in high grade malignant bone tumors.
 


Unicameral Bone Cyst of the proximal femur (lateral
view)

Unicameral Bone Cyst of the proximal femur (AP view)
Graft
taken from the ipsilateral fibula

 


Intraoperative picture showing the cyst filled with
fluid

 

post operative x-ray

 

The
cyst after applying the graft

 

Plain
X-Ray after complete healing of the graft

 

4 years follow up