Cyst-like defects following fractures in children

Area of Science:

• Pediatric Orthopedics
• Pediatric Radiology
• Pediatric Bone Healing

Background:

• Greenstick fractures are common incomplete fractures in children.
• These fractures involve the periosteum, leading to a subperiosteal hematoma and periosteal reaction.
• The study investigates unusual bone defects observed after pediatric greenstick fractures.

Observation:

• Nine children presented with radiolucent, cyst-like cortical defects.
• Lesions appeared weeks after greenstick fractures in the undamaged radius, proximal to the fracture line.
• Defects varied in size (3-7 mm diameter) and shape, often multiple and within the periosteal reaction zone.

Findings:

• Fracture healing remained unaffected despite the presence of these cyst-like defects.
• In three patients, the lesions resolved spontaneously within three years.
• The defects are characterized as benign resorption cysts linked to periosteal reaction and hematoma.

Implications:

• These findings help differentiate benign post-fracture bone changes from more serious conditions in children.
• Understanding these resorption cysts can reduce unnecessary patient anxiety and diagnostic procedures.
• Radiologists and orthopedic surgeons should be aware of these transient lesions following pediatric greenstick fractures.