Abstract
Treatment of unicameral bone cysts ranges from injections of corticosteroids, bone marrow with allogenic demineralised bone matrix to open bone grafting procedure. These procedures have their own disadvantages in form of infection, fracture, long-term morbidity, repeat procedure and high recurrence rate.
We describe here a new, technically simple and safe technique with minimal morbidity and short hospital stay. We treated 2 young children with active bone cyst (that did not heal with pathological fractures in past 18 months) by this technique and in both the cases bone cyst healed without any complications.
In patient with active bone cyst at the proximal end of humerus, under image intensifier control distal humerus perforated with 3.5 mm drill and a pre bent 2.5 mm, flexible, intramedullary nail passed into the medullary canal and then to proximal end of bone cyst. Nail now rotated sequentially at 5 mm intervals to destroy the architecture of the cyst completely until no resistance is felt. Wound closed with skin sutures and steristrips. Post operatively both children were comfortable and discharged home next day. In both cases cyst healed uneventfully.
Though we have small experience but technique looks very promising.
Correspondence should be addressed to BOOS at the Royal College of Surgeons, 35 - 43 Lincoln’s Inn Fields, London WC2A 3PN