Tibial cyst

The tibia is an incorrect definition of the bones of the lower leg (crus), in fact there are two of them - the tibia - os tibia and the fibula - os fibula. Therefore, a tibia cyst can develop in one of these structural parts of the leg.

Anatomically, the leg consists of the thigh, shin and foot, with the shin being the area of the lower limb from the heel to the knee joint. The entire shin is permeated with pain receptors, which are located in the muscles, ligaments, periosteum and tendons. The fibula is localized laterally - on the side relative to the middle of the shin, the tibia is located medially - inside, where it connects to the femur with the help of the knee joint. There are no such nerve endings inside the bone, where a cyst can form, so the neoplasm develops asymptomatically for a long time. Despite their strength, the tibia bones are quite vulnerable and an increasing cyst gradually destroys them.

A tibia cyst is most often diagnosed in children and adolescents during the period of intensive skeletal growth. The process begins when the blood supply and hemodynamics in the shin in particular and in the skeletal system as a whole are disrupted. Due to deficient blood circulation and disruption of bone tissue nutrition, lysosomal fermentation is activated, collagen fibers are destroyed, and glucoglycosamines and proteins are destroyed. Both SBCs (solitary bone cysts) and aneurysmal tumors can form in the tibia. The latter are the most aggressive and their growth is often provoked by injuries, bruises or falls.

The cyst looks like a slowly developing thickening inside the bone cavity; as the neoplasm grows, the degenerative process begins to manifest itself with clinical signs in the form of transient pain and changes in gait.

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Tibial cyst

The peak threshold for the development of tumor-like formations in the bone occurs in childhood - 10-14 years. The predominant localization of benign cysts is the lower limbs, when the cyst is formed in the femur, tibia and in the shoulder area. A bone cyst is a pathological cavity in the bone, as it grows, a thickening is formed in the bone tissue, its integrity and strength are destroyed.

The etiology of cysts has not yet been clarified, but it has been established that a tibia cyst is most often diagnosed in adolescence, much less often it is detected in people over 25-35 years old. And very rarely a cyst can be accidentally found during surgery for osteopathies in elderly patients. Violation of intraosseous hemodynamics leads to the development of bone tissue dystrophy, if the cyst is located in the bones of the leg, its growth can be influenced by the following factors:

• Hormonal age-related changes.
• The period of intensive growth of all skeletal bones is puberty.
• Constant stress on the shin during sports activities.
• An injury that provokes the onset of bone destruction in the presence of existing osteopathology.

Tibial cyst is classified as a benign tumor. In clinical practice, there have been no cases of malignancy of SCC or ACC in this area. A solitary cyst differs in symptoms from an aneurysmal cyst, it develops more slowly and is not accompanied by severe pain. ACC grows quickly, can manifest itself as swelling in the area of cyst formation, is accompanied by a fairly noticeable pain symptom that intensifies with movement, walking or running. An aneurysmal cyst can limit motor activity, cause changes in gait, lameness. A common symptom, clinical manifestation of both aneurysmal and solitary cysts, is a pathological fracture, which is not associated with objective trauma. A fracture is both the final sign of bone cysts and a kind of compensatory way for bone tissue, since after a fracture, the cyst collapses, its cavity decreases. However, a patient diagnosed with a bone cyst requires treatment and a long period of rehabilitation.

Treatment of tibia cysts in children begins with conservative methods; if a crack or fracture is suspected, a splint is applied to the shin to ensure immobilization and reduce the load on the leg. If the cyst is at a stage that provokes a spontaneous fracture, the leg is plastered for 4-6 weeks, then the patient is shown rehabilitation therapeutic exercise and joint development.

A bone cyst not complicated by a fracture is often subjected to multiple punctures, which are performed on an outpatient basis. If histology confirms the benign nature of the process, contrical, Hydrocortisone acetate (hydrocortisone acetate) or other drugs from the glucocorticosteroid class are injected into the patient's cyst cavity. As soon as the cyst subsides, the patient undergoes a course of therapeutic exercise and physiotherapy procedures.

It is very rare to diagnose a bone cyst of the shin in a timely manner; most often, patients seek help at an advanced stage of the disease, in 75-80% of cases due to a fracture. This causes a very long process of both treatment and recovery; the total time from the beginning of treatment to complete recovery can be 1.5-2 years. Children recover faster than adult patients, as their body's reparative abilities are much higher.

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Cyst of the fibula

Fibula - the fibula is a thin and long bone, consists of two epiphyses - the upper and lower and the body of the bone. A fibula cyst can be localized in all its parts, but is most often determined in the epiphysis. It should be noted that tumor-like neoplasms are extremely rare in this bone, they are often confused with other osteopathologies, although it is well known that both ABC (aneurysmal bone cyst) and SBC (solitary bone cyst) "prefer" large tubular bones. Such frequent diagnostic errors are associated with insufficient study of the etiopathogenesis of bone cysts in general, in addition, it is sometimes impossible to detect a cyst clinically due to its asymptomatic course. The only predominant sign of a bone tumor is a pathological fracture. Local compaction and thickening in the fibula does not cause subjective discomfort in patients until the integrity of the bone is compromised.

The main method for confirming the presence of a cystic neoplasm is radiography and computed tomography. The images clearly show

Local destruction, rarefaction of bone tissue, the cyst has a rounded shape with fairly clear sclerotic contours. Bone cyst of the fibula should be differentiated from chondroblastoma, eosinophilic granuloma, osteoclastoma (giant cell tumor), metaphyseal fibrous defect. Pathomorphological examination, biopsy can be a method of differentiation.

The main method of treating a cyst in this area is surgery, excochleation of the tumor and replacement of the defect with a bone implant. If the cyst is aggravated by a fracture, it is also removed, bone grafting is performed with mandatory fixation of the damaged parts of the bone with the Ilizarov apparatus. Fixation helps to reduce the risk of relapse, since the rods of the apparatus inserted into the tissue do not allow the formation of a tumor cavity, in addition, this method of pinning prevents the development of refracture (repeated bone fracture) and limitation of leg movements.

A combination of transosseous osteosynthesis, compression in the cyst cavity and parallel punctures every 2-4 weeks is also possible. Punctures are performed directly during the surgical intervention, during fixation of the fibula and during the following one and a half months. Fixation should last at least two months, the recovery period with mandatory X-ray control lasts at least a year.

In surgical practice, there are cases when a solitary cyst in the fibula in children depressurized itself as a result of a pathological fracture, the tumor cavity was eliminated within 3-4 months without relapse. This is due to the high reparative abilities of the child's body and timely diagnosis of the pathology.

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Treatment of tibia cyst

Treatment of a tibia cyst depends on the size of the tumor, the patient's age and concomitant pathologies, both acute and chronic. A large cyst is subject to surgical removal, a cyst up to 2-3 centimeters is observed for 3 months, the absence of positive dynamics, progression of the process and tumor growth are a direct indication for surgery.

Removal of a fibular cyst is much more difficult than treatment of a tibia cyst, this is due to the deeper location of the neoplasm and the complex access route during surgery.

General scheme of the operation of the tibia cyst:

• The cyst is subject to resection within the boundaries of healthy tissue.
• The resection defect is filled with osteotransplants, auto or allotransplants.
• The isolated cyst tissue – the wall and contents – must be sent for histology to exclude oncopathology.
• The recovery period lasts from 3 to 6 months, provided that the operation was successful and there is no relapse.
• Recurrence of the cyst is possible in case of technical errors during surgery and incomplete removal of the cyst.

A cyst of the tibia is most often found in the os tibia (tibia), so its treatment is considered quite complex, and the recovery period requires patience from the patient and compliance with all medical recommendations - undergoing a course of exercise therapy, developing the leg joint, following a certain calcium-containing diet and other rules.