Treatment of Unicameral Bone Cysts: A Comparison on the Use of Steroid Injection and Open Surgery

Aim: In this study we compared the clinical outcomes of the patients who underwent steroid injection and the ones who received additional local adjuvant therapy (cauterization + alcohol) following open surgery. Material and Method: The retrospective study included 73 patients who were diagnosed with unicameral bone cyst and underwent steroid injection or open surgery between 1995 and 2011. The patients comprised 23 (31.5%) females and 50 (68.5%) males, with a mean age of 9 (6-18) years and mean follow-up period of 4.71 (2-9) years. Open surgery was performed in 49 and steroid injection in 24 patients. In the open surgery group, local adjuvant treatment was added subsequently. In this group, healing was viewed radiologically. The patients were analyzed in three groups depending on the rate of the filling of the cystic area with a new bone: (I) complete healing, (II) residual healing, and (III) inadequate healing. Results: In the steroid injection group, complete healing was observed in 5 (20.8%), residual healing in 13 (54.1%), and complete failure in 6 (25%) patients. Average healing time was 32 (13-45) months. In the open surgery group, complete healing occurred in 24 (48.9%), residual healing in 20 (40.8%), and complete failure in 5 (10.2%) patients. Average healing time was 15 (10-29) months. Discussion: Steroid Injection is a practical and minimally-invasive method, yet it leads to a lower success rate when compared to open surgery combined with local adjuvant therapy.