Clinical outcome following surgical intervention for a solitary bone cyst: emphasis on treatment by curettage and steroid injection.
BACKGROUND
Solitary bone cysts are benign, fluid-filled, expansive lesions in children. The success rate of bone consolidation in the case of a solitary bone cyst is unpredictable following steroid injection.


METHODS
Among 24 patients with a solitary bone cyst, 11 (femur 8; pelvic bone 3) underwent curettage plus bone grafting for stabilization. The remaining 13 patients--8 long bones (humerus 6; femur 2) and 5 non-long bones (calcaneus 5)--underwent curettage plus steroid injections.


RESULTS
Among the 11 patients, 2 treated by curettage plus bone grafting suffered recurrence and needed a second procedure. One of the 13 patients treated by curettage plus steroid injection as the initial treatment later developed a pathological fracture and underwent bone grafting. The remaining 12 patients treated by curettage plus steroid injection eventually achieved bone consolidation, after an average of 1.6 injections (range 1-3). One injection was enough to achieve bone consolidation in two of seven of the long-bone cases (29%) and in all of the five non-long-bone cases.


CONCLUSIONS
Steroid injection remains a useful method for treating solitary bone cysts owing to its low invasiveness. The very favorable results achieved in the five calcaneus cases following a single steroid injection may be attributable to curettage. Regardless of the relatively small number of cases, the different prognosis between long bones and the calcaneus following the same procedure suggests a varying pathogenesis and/or etiology among solitary bone cysts.
Sakamoto
Akio
A
Department of Orthopaedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Fukuoka 812-8582, Fukuoka, Japan.
Matsuda
Shuichi
S
Yoshida
Tatsuya
T
Iwamoto
Yukihide
Y
D000293:Adolescent; D001845:Bone Cysts / Q000188:drug therapy* / Q000601:surgery*; D016025:Bone Transplantation; D002111:Calcaneus / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003475:Curettage; D005260:Female; D005269:Femur / Q000601:surgery; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D014457:Ulna / Q000601:surgery
D005938:Glucocorticoids; D008775:Methylprednisolone