Functional outcome of curettage and reconstruction with bone grafting or combined bone graft and cement (Sandwich Technique) in primary benign osseous tumors around Elbow: A prospective study

Author(s): Dr. Rahil Jiwani, Dr. Anil Khandekar, Dr. Nagesh Naik and Dr. Sunil Patil

Abstract: Background: Common benign bone lesions around elbow joint include giant cell tumors, chondroblastoma, simple bone cysts, fibrous dysplasia and osteoid osteoma. These lesions can be managed either by observation and follow up, curettage with bone-grafting or combined bone grafting and cementing (sandwich technique). In some cases wide excision is indicated. We conducted this prospective study to find out the functional outcomes after curettage and reconstruction using bone graft sandwich technique with or without internal fixation.
Materials and Methods: After obtaining approval from institutional ethical committee we conducted a prospective study of 25 patients diagnosed with benign osseous lesions around the elbow joint and who were managed with extended curettage and reconstruction using either bone grafting or sandwich technique. Patients having any exclusion criteria were excluded from the study. Patients were followed up at least for 1 year. Functional Outcomes were assessed according to Mayo Elbow Performance Score (MEPS) and Quick DASH scores. The data was tabulated and analyzed using SPSS 16.0 version software.
Results: Out of 25 studied cases there were 16 males and 9 females with a M: F ratio of 1:0.56. The benign lesions in the studied cases included Giant cell tumors (80%), chondroblastoma (12%) and simple bone cysts (8%). All patients were treated by curettage and reconstruction with bone grafting or combined bone graft and cement. Postoperatively patients were followed up at 1month, 6moths and 1 year. Majority of the patients (92%) were found to have either excellent or good outcome. the Mayo Elbow Performance Score (MEPS) was found to have improved statistically significantly. Quick Disabilities of Arm, Shoulder and Hand (Quick DASH) score was also found to have improved in all the patients and majority of the patients had either no or mild difficulty with a mean Quick Dash Score of 14.
Conclusion: Treatment of benign epiphyseal bone tumors by curettage with bone grafting or combined bone grafting and cementing (sandwich technique) was found to have good to excellent functional outcome. There were no patients with significant functional disability at the end of 1 year postoperatively.

DOI: https://doi.org/10.22271/ortho.2018.v4.i2f.52