Steroid injections in the treatment of humeral unicameral bone cysts: long-term follow-up and review of the literature

Eur J Orthop Surg Traumatol. 2014 May;24(4):497-503. doi: 10.1007/s00590-013-1211-4. Epub 2013 Apr 3.

Abstract

Background: Retrospective evaluation of long-term effectiveness of the steroid injections treatment in patients with unicameral bone cysts (UBC).

Methods: From January 1993 to April 2005, 23 children affected by proximal humeral UBC were evaluated according to the Neer-Cole classification system and treated with serial methylprednisolone acetate's injections. The patients were followed up at 1, 3, 6 and 12 months and then every year until the adolescence.

Results: After treatment, in 15 out of 23 patients (65.2%), the humeral cysts were referred, respectively, as Grade 1 and in four as Grade 2. In 4 patients, a refracture occurred. Statistical analysis showed an overall good response in 82.6% of patients at the end of the follow-up. Minor complication including skin discoloration accounted for 13.04%.

Conclusions: The steroid injections showed to be an alternative excellent treatment for UBC, with complete healing of the lesions in the majority of cases. This procedure is not expensive, mini-invasive, with low surgical risk and short hospitalization.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / administration & dosage
  • Bone Cysts / classification
  • Bone Cysts / diagnostic imaging
  • Bone Cysts / drug therapy*
  • Child
  • Child, Preschool
  • Female
  • Follow-Up Studies
  • Humans
  • Humeral Fractures / complications
  • Humeral Fractures / diagnostic imaging
  • Humerus / diagnostic imaging
  • Humerus / drug effects*
  • Injections
  • Kaplan-Meier Estimate
  • Male
  • Methylprednisolone / administration & dosage
  • Methylprednisolone / analogs & derivatives*
  • Methylprednisolone Acetate
  • Radiography
  • Retrospective Studies

Substances

  • Anti-Inflammatory Agents
  • Methylprednisolone Acetate
  • Methylprednisolone