Unicameral bone cyst treatment: injections, curettage, pathological fracture management. Dr. Priano, Milan.
Minimally invasive treatment for bone cysts
Learn about this condition →Injection of corticosteroid, autologous bone marrow, or bone substitutes into the cyst cavity through needles under general anesthesia.
Symptomatic or fracture-risk cysts as first approach.
Day hospital. Protected weight bearing for some weeks, with timing related to the site and size. The procedure may need to be repeated.
Surgical emptying of the cyst and filling with autologous bone graft or substitutes.
Recurrent cysts, cysts of significant size, or after an insufficient response to injections.
Protected weight bearing for some weeks, with timing varying by site and size. Results are generally good, with a possibility of recurrence especially in active cysts.
Bone cyst treatment depends on size, location, lesion activity and fracture risk. Minimally invasive techniques are often the first approach. The choice between observation, injections and surgery is discussed with the family based on the specific case. The course described below is an indicative pathway, personalised after the procedure.
Note: This is an indicative pathway, personalised after surgery. Some elements are relatively stable (goal of the procedure, approximate hospital stay, presence of a cast or brace); others depend on the individual case (weight bearing, range of motion, imaging, sport, hardware removal, follow-up intervals) and on the surgical technique chosen.
Day-surgery for injections. Usually one night for curettage.
Protected weight bearing with crutches as instructed: generally shorter after injection and longer after curettage.
Progressive weight bearing, with X-ray checks to monitor healing. Injections may be repeated if needed.
After curettage healing is usually well advanced. After injection more than one treatment may be needed: the response varies with site, cyst activity and age.
Indicative pathway: return to sport generally occurs within some weeks after injection and within a few months after curettage. Contact sports are reintroduced after healing is confirmed.
Scheduled clinical and radiographic checks during the first year, with modulated intervals. Monitoring for recurrence, especially in 'active' cysts near the growth plates.
Injections: may require multiple procedures. Curettage: recurrence, infection (rare). Pathological fracture: usually heals well and may help cyst resolution.
Causes, diagnosis, conservative options and when surgery is considered.
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