Background
Peritrochanteric benign lesions are common in skeletally immature patients, which might cause limping and bone destruction up to pathological fracture. Many techniques have been described for the treatment of such lesions; curettage is one of them, which may be combined with bone graft and internal fixation. Curettage without internal fixation is the principal technique used in this study.
Patients and methods
This study included 20 patients, with 12 males and eight females, and their mean age was 10.6 years (range, 4–15 years). The diagnosis was 12 cases of simple bone, three cases of aneurysmal bone cyst, two cases of fibrous dysplasia, two cases of nonossifying fibroma, and one case of osteoid osteoma. Treatment included curettage, either simple or extended by high-speed burr and phenol adjuvant, and only cast as external immobilization. Patients were placed in hip spica or antirotational cast for 6–8 weeks. The visual analog scale (VAS) and Harris hip score (HHS) were used for preoperative and postoperative clinical and functional assessments.
Results
The mean follow-up period was 30.5 months. Clinically, 17 patients had full recovery 3–6 months postoperatively with excellent results according to HHS for hip function and VAS for pain assessment. The VAS score decreased highly significantly, which denoted pain improvement after treatment. HHS increased highly significantly, which denoted improvement of functional activity after treatment. Three patients developed complications.
Conclusion
Curettage without internal fixation and its replacement by external immobilization by cast is effective, less morbid, and technically simple procedure for the treatment of peritrochanteric benign lesions in skeletally immature patients. Good satisfactory results in local tumor control and excellent long-term functional and radiological results with less emotional negative effects on the patient or his family have been recorded.