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Single Flexible Nailing of the Humerus for Recurrent Bone Cysts
Nakul S Talathi1, Casey C Kuka1, Alexandre Arkader1
1Children's Hospital of Philadelphia, Philadelphia, PA, USA.
None:
Unicameral bone cysts (UBCs) in the proximal humerus are prone to pathologic fractures. We have discovered that using a single flexible nail, along with comprehensive curettage and grafting of humeral UBCs, is effective for safeguarding the bone and facilitating an early return to activity. Employing just one nail offers several advantages: technical simplicity in contouring and inserting a single nail, reduced surgical time, and elimination of a medial distal humeral dissection while ensuring stable internal fixation and promoting early motion even in cases of cyst recurrence. Our indications, surgical techniques, and helpful tips are outlined in this article.
Key Concepts:
(1)Curettage and flexible intramedullary nailing with a single nail for treating pediatric humeral unicameral bone cysts is an effective prophylactic fixation strategy.(2)This enables ongoing activity even in the presence of cyst recurrence;-; in essence, "protect the bone and forget the cyst."(3)The judicious use of fluoroscopy, the appropriate starting point, and a suitably bent flexible nail allow for the straightforward passage of the nail into the humerus.
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