Juvenile bone cysts in children and adolescents are often discovered incidentally or in connection with a pathologic fracture. Although the diagnostic procedure in this type of lesion affecting the skeleton has become uniform, the treatment varies according to the principles established at different clinics. The aim of our study was to compare two Methods: applied in the treatment of juvenile bone cysts, i.e. the established method of a series of Methylprednisolone injections and a new mini-invasive method using a Tricalcium phosphate.

In both groups of patients, we performed an evaluation of the number of required surgeries, general anaesthesias and subsequent hospitalizations (including the length of hospitalization), the treatment results and the interval between surgery and complete cyst healing using Neer’s evaluation criteria. The group of patients treated with Methylprednisolone consisted of 24 patients and the group of patients treated with Tricalcium phosphate comprised 20 patients.

The outcome of the statistical analysis proves that in patients treated with Tricalcium phosphate significantly better results were obtained compared to patients where Methylprednisolone was applied. A subsequent surgery (additional application) was necessary only in two Tricalcium phosphate patients (10%) compared to nineteen Methylprednisolone patients (79%). The average length of hospitalization was 4 days in Tricalcium phosphate patients and 3.5 days in Methylprednisolone patients. Excellent and good results according to the Neer classification were documented in eighteen Tricalcium phosphate patients (19%) and in twelve Methylprednisolone patients (50%).

The treatment of juvenile bone cysts with a biocompatible resorbable synthetic filler Tricalcium phosphate helps reduce the number of surgeries necessary for complete cyst healing and produces better results in terms of Neer’s evaluation criteria of bone cyst treatment results compared to the application of Methylprednisolone into the cyst.

This work was supported by the Internal Grant Agency of the Ministry of Health of the Czech Republic (NS9860-3/2008).

In this prospective study, 35,550 neonates were examined shortly after birth by a team of orthopaedic surgeons. They diagnosed 775 unstable or dislocated hips in 656 babies; there were two teratological dislocations. Treatment was first with a Frejka pillow and, if this failed to give a normal hip, a Pavlik harness at three months. Early clinical examination did not identify 21 infants who were found to have subluxation or dislocation of the hip at the three-month review. The number of missed cases declined during the study, however, reflecting the increasing experience of the examiners. One case of avascular necrosis occurred in the group treated from birth and one in the late-diagnosed group. Open reduction was necessary only in the two teratological dislocations. Experienced examiners are needed for accurate clinical diagnosis; and treatment should be started before the baby is discharged from the maternity ward.