Revision Reconstruction of a Humeral Simple Bone Cyst Using Fibular Strut Graft, Iliac Crest Bone Graft, and...

Simple bone cysts, also known as unicameral or solitary bone cysts, are benign, fluid-filled lesions typically found in long bones, particularly in children and adolescents. The size, location, and symptoms of the cyst determine the course of treatment; approaches range from observation and periodic monitoring to surgical intervention.

We report a case treated for a humeral simple bone cyst. A 15-year-old female patient has a history of left humerus titanium elastic nailing system (TENS) nailing for midshaft humerus fracture 9 years ago. Single TENS nail removal was done 8-month post-surgery. The patient has a history of blunt trauma to the operative site 3 months ago, following which the patient developed pain and swelling of the left arm. Curettage of cyst wall followed by non-vascularized fibula strut grafting and iliac crest bone grafting with posterior humerus plating done. Early post-operative mobilization was started.

Patients demonstrated significant pain reduction and improved range of motion within 6 weeks postoperatively. Radiographic assessments at 3 months showed near complete integration of the grafts, with signs of new bone formation around the surgical site. The alignment of the humerus was maintained, and there were no instances of hardware failure or recurrence of the cyst noted during follow-up.

The above intervention demonstrates an effective approach to restoring structural integrity and promoting healing. This multimodal approach reduces the risk of complications like fractures and recurrence by strengthening the surrounding bone in addition to treating the cyst itself. Continued monitoring and follow-up are essential to assess long-term success and any potential need for further intervention.