{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T20:39:32Z","timestamp":1790282372188,"version":"4.1.0"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Purpose<\/jats:title><jats:p>The aim of this study was to evaluate the surgical outcomes of proximal femoral bone cysts in pediatric patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively analyzed 41 pediatric patients (31 males and 10 females, mean age 7.47\u2009\u00b1\u20092.67 years, range 2.03\u201314.67 years) diagnosed with proximal femoral bone cysts treated at a single institute between March 2009 and November 2021. Data included demographics, preoperative details, intraoperative conditions, surgical techniques, postoperative outcomes, recurrence, and complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the participants, 68% presented with simple bone cysts and 32% with aneurysmal bone cysts. Prior to surgery, 32% exhibited pathological fractures. Surgical methods included lesion curettage, defect filling using allograft bone and Minimally-Invasive Injectable Graft \u00d73, and varied fixation techniques. Postoperative recurrence (17%) was associated with cyst location between the capital femoral epiphysis and the linea intertrochanterica (<jats:italic>P<\/jats:italic>\u2009=\u20090.010). At the final assessment (mean follow-up: 26.51\u2009\u00b1\u200918.99 months), all showed radiological bony union with 93% rated as \u201cgood\u201d and 7% as \u2018fair\u2019 based on Ratliff hip scores. Complications arose in 20% of patients, significantly correlated with prior pathological fractures (<jats:italic>P<\/jats:italic>\u2009=\u20090.007) and their association with the linea intertrochanterica (<jats:italic>P<\/jats:italic>\u2009=\u20090.004). Those with fractures reported higher intraoperative blood loss (<jats:italic>P<\/jats:italic>\u2009=\u20090.015) and longer surgery durations (<jats:italic>P<\/jats:italic>\u2009=\u20090.012) compared to those without.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Treating pediatric proximal femoral bone cysts using techniques such as lesion curettage, defect filling, and selective internal fixation yields favorable outcomes. The presence of pathological fractures can prolong surgical time, increase intraoperative blood loss, and elevate postoperative complication risks. Hence, early surgical intervention for these cysts is recommended to prevent fractures.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2024.1331089","type":"journal-article","created":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T04:43:27Z","timestamp":1719204207000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Surgical outcomes of proximal femoral bone cysts in pediatric patients: a retrospective study of 41 cases"],"prefix":"10.3389","volume":"12","author":[{"given":"Taichun","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenzhen","family":"Dai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qichao","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziming","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,24]]},"reference":[{"key":"B1","article-title":"Bone cyst","volume-title":"StatPearls [Internet]","author":"Subramanian","year":"2024"},{"key":"B2","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1097\/BPO.0000000000002267","article-title":"Do's and don'ts in primary aneurysmal bone cysts of the proximal femur in children and adolescents: retrospective multicenter EPOS study of 79 patients","volume":"43","author":"van Geloven","year":"2023","journal-title":"J Pediatr Orthop"},{"key":"B3","doi-asserted-by":"publisher","first-page":"S149","DOI":"10.1016\/j.otsr.2015.05.010","article-title":"Pathological fractures in children: diagnosis and treatment options","volume":"102","author":"Canavese","year":"2016","journal-title":"Orthop Traumatol Surg Res"},{"key":"B4","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1097\/01.blo.0000155375.88317.6c","article-title":"Pathologic fractures in children","volume":"432","author":"Ortiz","year":"2005","journal-title":"Clin Orthop Relat Res"},{"key":"B5","doi-asserted-by":"publisher","first-page":"615","DOI":"10.1007\/s00402-020-03687-x","article-title":"Surgical treatment of benign lesions and pathologic fractures of the proximal femur in children","volume":"142","author":"Tomaszewski","year":"2022","journal-title":"Arch Orthop Trauma Surg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"51","DOI":"10.4103\/ortho.IJOrtho_209_17","article-title":"Benign aggressive lesions of femoral head and neck: is salvage possible?","volume":"52","author":"Panchwagh","year":"2018","journal-title":"Indian J Orthop"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1051","DOI":"10.1007\/s00402-016-2486-9","article-title":"A treatment strategy for proximal femoral benign bone lesions in children and recommended surgical procedures: Retrospective analysis of 62 patients","volume":"136","author":"Erol","year":"2016","journal-title":"Arch Orthop Trauma Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"68","DOI":"10.55095\/achot2022\/009","article-title":"Pathological fractures of the proximal femur in children and adolescents treated with LCP paediatric hip plate","volume":"89","author":"Patrikov","year":"2022","journal-title":"Acta Chir Orthop Traumatol Cech"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e661","DOI":"10.1097\/BPO.0000000000002128","article-title":"Treatments and sequelae of pediatric pathologic proximal femur fractures due to benign bone cyst","volume":"42","author":"Lin","year":"2022","journal-title":"J Pediatr Orthop"},{"key":"B10","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1007\/s00264-017-3648-2","article-title":"Locking plate and fibular strut-graft augmentation in the reconstruction of unicameral bone cyst of proximal femur in the paediatric population","volume":"42","author":"Jamshidi","year":"2018","journal-title":"Int Orthop"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1447","DOI":"10.2106\/00004623-200010000-00011","article-title":"Flexible intramedullary nailing for the treatment of unicameral bone cysts in long bones","volume":"82","author":"Roposch","year":"2000","journal-title":"J Bone Joint Surg Am"},{"key":"B12","doi-asserted-by":"publisher","first-page":"2299","DOI":"10.1007\/s00264-012-1643-1","article-title":"The locking compression paediatric hip plate: technical guide and critical analysis","volume":"36","author":"Joeris","year":"2012","journal-title":"Int Orthop"},{"key":"B13","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1007\/BF00268511","article-title":"Unicameral bone cysts. 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