Unicameral bone cyst with fracture

Area of Science:

• Orthopedic Surgery
• Pediatric Orthopedics
• Pediatric Radiology

Background:

• Unicameral bone cysts (UBCs) are benign bone lesions often presenting with pathological fractures.
• Management of UBCs, particularly after fracture, remains a topic of debate in pediatric orthopedics.
• Conservative fracture management is increasingly considered for UBCs to avoid invasive procedures.

Observation:

• A 13-year-old male patient with a unicameral bone cyst of the proximal humerus sustained a pathological fracture.
• The fracture was managed conservatively, leading to obliteration of the cyst.
• No refracture or recurrence was noted during the follow-up period.

Findings:

• Conservative management of pathological fractures associated with unicameral bone cysts can lead to successful fracture union and cyst resolution.
• The literature presents uncertainty regarding refracture rates and spontaneous cyst healing after pathological fractures.
• Delayed invasive procedures allow for natural healing processes to occur.

Implications:

• Conservative fracture management should be the initial approach for unicameral bone cysts with pathological fractures in pediatric patients.
• Minimally invasive treatments like methylprednisolone acetate injections are recommended for non-healing or persistent cysts.
• Surgical interventions such as curettage and bone grafting are reserved for complex or refractory cases.