Treatment
Surgical therapy is not necessarily necessary, since a juvenile bone cyst can regress on its own. Conservative therapy includes limiting activity. Nevertheless, fractures can occur, which often heal on the thigh into an bow-leg or knock-knees.
If there is no spontaneous regression, the cyst can be cleared out (perform a curettage) and then filled up with cancellous bone (bone material). This is probably the safest treatment method. However, the insertion of a decompression screw or the instillation of cortisone can also lead to healing.
However, there is no causal therapy for juvenile bone cysts. Recurrences and fractures can occur with any type of treatment. The juvenile bone cyst can sometimes regress spontaneously and be symptom-free.
However, if this is not the case and the juvenile bone cyst causes pain and fractures to the affected person, the indication for surgical treatment must be given. If there is a fracture of the bone in which the bone cyst is located, the surgical therapy of choice is stabilization of the fracture with “elastically stable intramedullary nailing” (abbreviated: ESIN). These are very flexible and, as the name suggests, elastic nails, which are mainly used to stabilize a fracture in children with still open growth joints.
ESIN is mainly used on long tubular bones, as well as on the upper arm, the most common site of manifestation of juvenile bone cysts. In addition, this procedure is particularly suitable when the growth plate is not yet closed. This is usually the case at the time of surgical treatment of the juvenile bone cyst in childhood.
Another possibility is to remove the bone cyst intraoperatively from a certain size onwards and to fill it up again with cancellous bone material, which is normally located in the interior of the bone. This is considered a relatively safe procedure, which can prevent a fracture.
