Management strategy for unicameral bone cyst.
The management of a unicameral bone cyst varies from percutaneous needle biopsy, aspiration, and local injection of steroid, autogenous bone marrow, or demineralized bone matrix to the more invasive surgical procedures of conventional curettage and grafting (with autogenous or allogenous bone) or subtotal resection with bone grafting. The best treatment for a unicameral bone cyst is yet to be identified. Better understanding of the pathology will change the concept of management. The aim of treatment is to prevent pathologic fracture, to promote cyst healing, and to avoid cyst recurrence and re-fracture. We retrospectively reviewed 17 cases of unicameral bone cysts (12 in the humerus, 3 in the femur, 2 in the fibula) managed by conservative observation, curettage and bone grafting with open reduction and internal fixation, or continuous decompression and drainage with a cannulated screw. We suggest percutaneous cannulated screw insertion to promote cyst healing and prevent pathologic fracture. We devised a protocol for the management of unicameral bone cysts.
Chuo
Chin-Yi
CY
Department of Orthopedic Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Fu
Yin-Chih
YC
Chien
Song-Hsiung
SH
Lin
Gau-Tyan
GT
Wang
Gwo-Jaw
GJ
D000293:Adolescent; D000328:Adult; D001845:Bone Cysts / Q000601:surgery*; D001857:Bone Matrix; D001863:Bone Screws; D016025:Bone Transplantation / Q000379:methods; D002648:Child; D003475:Curettage / Q000379:methods; D005260:Female; D005598:Fractures, Spontaneous / Q000517:prevention & control; D006801:Humans; D015552:Injections, Intralesional / Q000379:methods; D008297:Male