Humeral Simple Bone Cysts: Observational Versus Interventional Management. Issue 6 (July 2019)

• Record Type: Journal Article
• Authors: Green, Natalie M.; Pagkalos, Joseph; Jeys, Lee M.; Stevenson, Jonathan D.; Gregory, Jonathan J.
• Is Part Of: Journal of pediatric orthopaedics. Volume 39:Issue 6(2019)
• Publication Date: 2019-07
• Subjects: simple bone cyst -- unicameral bone cyst -- fracture -- observation -- intervention; Pediatric orthopedics -- Periodicals; 618.927
• DOI: 10.1097/BPO.0000000000001344
• Languages: English
• ISSNs: 0271-6798

Abstract

Abstract : Aims: Our study aims to review the outcomes of conservative and interventional management of simple bone cysts (SBC) in the humerus. Methods: We retrospectively reviewed our center's prospectively collected database. All patients with a diagnosis of a humeral SBC and a minimum of 1-year follow-up or complete healing and discharge within the first year were included. Cyst radiographic measurements were collected for all patients with available radiographs. A successful outcome included fully or partially healed cysts with persistent and recurrent cysts marked as unsuccessful. Results: In total, 91 patients were included in the study. Within the observational group, 44 patients (95.7%) achieved a successful outcome versus 38 patients (84.4%) in the interventional group. The 15/61 (25%) patients who were treated with observation at presentation required intervention at a later stage. The 9/30 (30%) of patients who had intervention at presentation required further additional intervention. Seven patients (11%) presenting with a fracture through a SBC went on to complete consolidation of the cystic lesion following the injury at a mean of 92.9 days (maximum, 176 d). Conclusions: We observed similar outcomes with conservative and interventional management in our retrospective series. We recommend observational management when a radiologic diagnosis is possible with intervention reserved for cases of diagnostic uncertainty and intrusive symptoms. Level of Evidence: Level III—a retrospective case comparison study.