What Is the Treatment of Solitary Bone Cyst, Including When Pathological Fracture Is Present?
Solitary bone cysts (SBCs) are benign, fluid-filled lesions most commonly found in the long bones. Many remain asymptomatic; others first present through a pathological fracture. The appropriate clinical approach depends on the individual presentation, and spontaneous healing is a recognised outcome in a subset of cases.
Conservative management forms the basis of the clinical approach for solitary bone cysts; the specific criteria, indications, and full clinical pathway are detailed in the structured protocol.
- Fracture healing within six weeks in the presence of a pathological fracture
- Stable situation without clinical symptoms
- Absence of radiographic progression of the cyst
References
DOI: 10.1016/j.jbo.2021.100384
In the majority of cases SBCs can be treated conservatively, especially in the upper extremity.
Concluding, symptomatic but unfractured SBCs of the upper extremity do not need any treatment.
Regarding the uncomplicated healing potential and the lack of relevant secondary axis deviations the majority of pathological fractures caused by SBCs of the upper extremity can successfully be treated conservatively.
In uncomplicated cysts with or without pathological fracture the authors rather underlined the possibility of spontaneous healing.
All 32 pathological fractures treated conservatively, healed within six weeks.
No relevant secondary angular or torsional deformity was observed after treatment.
Hardes et al. regard a stable situation without clinical symptoms, lack of radiographic progression of the cyst or an incomplete healing as an acceptable intermediate result.
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