Juxtaphyseal aneurysmal bone cysts

Aneurysmal bone cysts are benign primary or secondary lesions that commonly arise in long bones and often before skeletal maturity. Little has been wr itten about aneurysmal bone cysts that abut the physeal plate. The records of 15 patients with juxtaphyseal aneurysmal bone cysts were reviewed. Fourt een of the patients were referred with abnormal radiographs after evaluatio n for pain in the affected limb. One patient presented with abnormal radiog raphs after fracture about the aneurysmal bone cyst. None of the patients h ad evidence of growth plate disruption. The children's ages ranged from 2 t o 14 years, with a mean of 9.8 years. There were 10 boys and five girls. Le sion locations included: six in the proximal tibia, three in the distal fib ula, two in the distal tibia, two in the proximal femur, one in the distal femur, and one in the distal radius. All of the lesions abutted the physeal plate and fell into one of the types in Campanacci's classification of jux taphyseal aneurysmal bone cysts. Three lesions were classified as Type 1, e ight were Type 2, and four were Type 3, This study included no cases of Typ e 4 or 5 lesions, Treatment of all lesions consisted of excision, curettage , and bone grafting with care taken to preserve the growth plate. Adjunctiv e cauterization was performed in two cases. There were no incidences of pos toperative physeal plate arrest. Overgrowth of the fibula occurred in one p atient. Three patients experienced recurrent lesions. One of the children u nderwent repeat curettage and bone grafting with no additional recurrence. In the other two children with recurrence, the lesion had grown away from t he physeal plate while remaining static in size and asymptomatic, Based on this study, juxtaphyseal aneurysmal bone cysts may be treated satisfactoril y with intralesional surgery and bone grafting with expectation of normal p hyseal growth.