Guity M, Saberi S, Moetamedi M,
Volume 65, Issue 1 (3-2008)
Abstract
Background: Simple bone cyst is a common benign lesion in the proximal humerus,
especially in prepubertal children. Up to 75 percent of patients with the bone cyst have a
pathologic fracture and the most significant complication is recurrent pathologic fracture.
Since the process of spontaneous healing of these fractures is rare, treatment is required.
Ideal treatment for simple bone cyst should stabilize pathologic fractures, assist healing
and provide a quick return to normal activity with reduced complication and recurrence.
Methods: In this descriptive case series study, 24 patients with simple bone cysts of the
humerus were selected for retrograde flexible intramedullary nailing from the lateral
cortex of the distal humerus, since 2000 to 2005 at Imam Khomeini Hospital, Tehran.
The mean age of the patients was 14.4 years, ranging from 6-39 years. Results were
evaluated by plain radiography using the classification system of Capanna et al.
Results: The mean duration of follow up for 23 of the patients was 31 (9-51) months.
One patient with short-term of follow-up was excluded. Of these patients, 91.3% were
healed either completely (65.2%) or with residual minor defect (26.1%). Only one cyst
(4.3%) persisted with no response to treatment and one patient (4.3%) had a recurrence of
the cyst. However, there was no instance of recurrent pathologic fracture among these
patients.
Conclusion: This study shows that flexible intramedullary nailing is an effective
treatment for humeral simple bone cysts that reduces the chance of complication,
recurrence of cyst or pathologic fracture. This technique provides sufficient stability for
quick return to normal activity.
