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. 2019 Jul;39(6):e472-e477.
doi: 10.1097/BPO.0000000000001344.

Humeral Simple Bone Cysts: Observational Versus Interventional Management

Natalie M Green  1 , Joseph Pagkalos  1 , Lee M Jeys  1   2 , Jonathan D Stevenson  1   2 , Jonathan J Gregory  1   3
Affiliations

Humeral Simple Bone Cysts: Observational Versus Interventional Management

Natalie M Green et al. J Pediatr Orthop. 2019 Jul.

Abstract

Aims: Our study aims to review the outcomes of conservative and interventional management of simple bone cysts (SBC) in the humerus.

Methods: We retrospectively reviewed our center's prospectively collected database. All patients with a diagnosis of a humeral SBC and a minimum of 1-year follow-up or complete healing and discharge within the first year were included. Cyst radiographic measurements were collected for all patients with available radiographs. A successful outcome included fully or partially healed cysts with persistent and recurrent cysts marked as unsuccessful.

Results: In total, 91 patients were included in the study. Within the observational group, 44 patients (95.7%) achieved a successful outcome versus 38 patients (84.4%) in the interventional group. The 15/61 (25%) patients who were treated with observation at presentation required intervention at a later stage. The 9/30 (30%) of patients who had intervention at presentation required further additional intervention. Seven patients (11%) presenting with a fracture through a SBC went on to complete consolidation of the cystic lesion following the injury at a mean of 92.9 days (maximum, 176 d).

Conclusions: We observed similar outcomes with conservative and interventional management in our retrospective series. We recommend observational management when a radiologic diagnosis is possible with intervention reserved for cases of diagnostic uncertainty and intrusive symptoms.

Level of evidence: Level III-a retrospective case comparison study.

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