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Management of Humeral Solitary Bone Cysts in Children Using Elastic Stable Intramedullary Nailing-A Safe and
Zoltán Derzsi1,2, Evelyn Kovács2, Arpad Solyom3,4
1Department of Pediatric Surgery and Orthopedics, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 38 Gheorghe Marinescu Street, 540142 Targu Mures, Romania.
Insights
Elastic stable intramedullary nailing (ESIN) effectively treats pediatric humeral solitary bone cysts (SBCs), promoting healing and restoring function. This method shows reliable stabilization with low recurrence and complication rates in children.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Pediatric radiology
Background:
- Solitary bone cysts (SBCs) are benign bone lesions that can affect children.
- Humeral SBCs can lead to pathological fractures and functional deficits.
- Elastic stable intramedullary nailing (ESIN) is a surgical technique used for bone stabilization.
Purpose of the Study:
- To evaluate the radiological and clinical outcomes of ESIN for pediatric humeral SBCs.
- To assess healing, recurrence, complications, and functional recovery after ESIN treatment.
- To determine the efficacy of ESIN in managing humeral SBCs in children.
Main Methods:
- Retrospective study of 25 children with humeral SBCs treated with ESIN.
- Minimum follow-up of 12 months.
- Radiographic healing assessed by Capanna classification; clinical outcomes included pain, range of motion, complications, refracture, and recurrence.
Main Results:
- Median age of patients was 11 years; 56% had pathological fractures.
- Cyst dimensions significantly decreased post-treatment (p < 0.001).
- Complete healing (Capanna I) in 64%, incomplete healing (Capanna II) in 28%, and recurrence (Capanna III) in 8%; no complications or refractures; pain resolved and full range of motion restored in all patients.
Conclusions:
- ESIN provides reliable stabilization for pediatric humeral SBCs.
- ESIN promotes cyst healing and leads to excellent functional outcomes.
- Low recurrence rates observed with ESIN treatment for humeral SBCs.
Background/Objectives:
The radiological and clinical outcomes of elastic stable intramedullary nailing (ESIN) for pediatric humeral solitary bone cysts (SBCs) were assessed, with particular attention to healing, recurrence, complications, and functional recovery.
Methods:
This retrospective institutional study included 25 children with humeral solitary bone cysts treated with elastic stable intramedullary nailing between January 2019 and December 2025. Patients treated exclusively with ESIN and with a minimum follow-up of 12 months were included. Radiographic healing was assessed using the Capanna classification. Clinical outcomes included pain, range of motion, complications, refracture, and recurrence.
Results:
The cohort consisted of 16 boys (64%) and 9 girls (36%), with a median age of 11 years. Pathological fractures were present in 56% of cases. A total of 29 surgical procedures were performed, including growth-related implant exchanges in selected patients. Cyst dimensions decreased progressively during follow-up (p < 0.001). At final evaluation, 64% of lesions demonstrated complete healing (Capanna I), 28% incomplete healing (Capanna II), and 8% recurrence (Capanna III); no cases of non-response were observed. No recurrent fractures or postoperative complications occurred. Pain resolved within one month in all patients, and a full range of motion was restored.
Conclusions:
Elastic stable intramedullary nailing appears to provide reliable stabilization and promotes cyst healing in pediatric humeral SBCs, with low recurrence rates and excellent functional outcomes.
