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Growth arrest resulting from unicameral bone cyst

R P Stanton1, M M Abdel-Mota'al

  • 1duPont Hospital for Children, Wilmington, Delaware 19899, USA.

Journal of Pediatric Orthopedics
|April 8, 1998
PubMed
Summary

Unicameral bone cysts in the proximal humerus can cause growth arrest in pediatric patients. This complication, seen in 10% of cases, leads to limb length discrepancies and requires careful monitoring.

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Area of Science:

  • Pediatric Orthopedics
  • Skeletal Dysplasias
  • Bone Pathology

Background:

  • Unicameral bone cysts (UBCs) are benign bone lesions often affecting children and adolescents.
  • Complications of UBCs can include pathological fractures and growth disturbances.
  • The proximal humerus is a common site for UBCs, potentially impacting upper limb growth.

Observation:

  • A series of five patients (10% of 51 consecutive cases) presented with growth arrest secondary to proximal humerus UBCs.
  • Patients ranged from 6 to 14 years at initial presentation, with follow-up up to 57.2 months.
  • Pathologic fracture was the consistent initial clinical presentation across all affected patients.

Findings:

  • Growth arrest was diagnosed via limb-length discrepancies and radiographic evidence of physeal (growth plate) closure and humeral deformity.

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  • In two cases treated surgically, growth arrest was evident pre-operatively.
  • The exact etiology of growth arrest in UBCs remains unclear, with direct physeal damage deemed unlikely.

    • Implications:

    • Growth arrest is a more frequent complication of proximal humerus UBCs than previously recognized.
    • Early recognition and monitoring are crucial for managing growth disturbances in pediatric patients with UBCs.
    • Further research is needed to elucidate the mechanisms underlying UBC-associated growth arrest.