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The safety and clinical outcomes of a combined mechanical and biological treatment with elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma are evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From 02\/07 to 01\/09 we offered all children with bone cysts the treatment combination of elastic intramedullary nailing (ESIN), artificial bone substitute (Orthoss<jats:sup>\u00ae<\/jats:sup>) and autologous platelet rich plasma, concentrated by the Gravitational Platelet Separation (GPS<jats:sup>\u00ae<\/jats:sup>) - System. All patients were reviewed radiologically for one year following the removal of the intramedullary nailing, which was possible because of cyst obliteration.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A cohort of 12 children (4 girls, 8 boys) was recruited. The mean patient age was 11.4 years (range 7-15 years). The bone defects (ten humeral, two femoral) included eight juvenile and four aneurysmal bone cysts. Five patients suffered from persistent cysts following earlier unsuccessful treatment of humeral bone cyst after pathologic fracture; the other seven presented with acute pathologic fractures. No peri- or postoperative complications occurred. The radiographic findings showed a total resolution of the cysts in ten cases (Capanna Grade 1); in two cases a small residual cyst remained (Capanna Grade 2). The intramedullary nails were removed six to twelve months (mean 7.7) after the operation; in one case, a fourteen year old boy (Capanna Grade 2), required a further application of GPS<jats:sup>\u00ae<\/jats:sup>and Orthoss<jats:sup>\u00ae<\/jats:sup>to reach a total resolution of the cyst. At follow-up (20-41 months, mean 31.8 months) all patients showed very good functional results and had returned to sporting activity. No refracture occurred, no further procedure was necessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combination of elastic intramedullary nailing, artificial bone substitute and autologous platelet rich plasma (GPS<jats:sup>\u00ae<\/jats:sup>) enhances the treatment of bone cysts in children, with no resulting complications.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-2474-12-45","type":"journal-article","created":{"date-parts":[[2011,2,12]],"date-time":"2011-02-12T19:14:07Z","timestamp":1297538047000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Elastic Stable Intramedullary Nailing (ESIN), Orthoss\u00ae and Gravitational Platelet Separation - System (GPS\u00ae): An effective method of treatment for pathologic fractures of bone cysts in children"],"prefix":"10.1186","volume":"12","author":[{"given":"Marion","family":"Rapp","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Svoboda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas M","family":"Wessel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin M","family":"Kaiser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2011,2,12]]},"reference":[{"key":"1075_CR1","first-page":"369","volume-title":"\u00dcber die Bildung von Knochencysten","author":"R Virchow","year":"1876","unstructured":"Virchow R: On the formation of bony cysts. \u00dcber die Bildung von Knochencysten. 1876, Berlin: S-B Akad Wiss, 369-81."},{"issue":"6","key":"1075_CR2","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1097\/01202412-200411000-00008","volume":"13","author":"J Cottalorda","year":"2004","unstructured":"Cottalorda J, Kohler R, Sales de Gauzy J, Chotel F, Mazda K, Lefort G, Louahem D, Bourelle S, Dimeglio A: Epidemiology of aneurysmal bone cyst in children: a multicenter study and literature review. 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