[A new technique for aneurysmal bone cysts of the proximal humerus: cortical collapsing]

We evaluated the results of a new technique developed for aneurysmal bone cysts centrally located in the proximal humeral metaphysis leading to widespread destruction.

The study included seven patients (5 boys, 2 girls; mean age 12.8 years; range 9 to 15 years) who were treated with cortical collapsing and massive fibular autograft for centrally located aneurysmal bone cysts in the proximal humeral metaphysis leading to widespread destruction. All the patients had type II and active tumors according to the criteria of Capanna et al. and Campanacci et al., respectively. Final evaluations included six patients because one patient was lost to follow-up. The mean follow-up period was 49 months (range 12 to 105 months).

No complications were seen in the early postoperative period. Radiographic examination showed partial recurrence in two patients; of whom, one patient underwent curettage and bone grafting in the postoperative second year because of pain and discomfort. No deformity was observed. One patient developed shortening of 0.5 cm. Radiographically, all the patients exhibited metaphyseal remodelling one year after surgery. Function of the shoulder joint was near-normal in all the patients.

In this technique, cortical collapsing reduces the amount of bone graft used, and massive fibular strut grafting provides structural support to prevent deformities.