Surgical treatment of proximal femur unicameral bone cysts in children: a retrospective single-center study.

Objective: The aim of this study was to present clinical and radiological outcomes of surgical treatment for proximal femur unicameral bone cysts (UBCs) in children.

Methods: Pediatric patients recruited from our institution between 2015 and 2024 with proximal femur UBC were analyzed retrospectively. Patients were divided into two groups according to whether internal fixation was used. Demographics, cyst activity, cyst area, healing time of pathological fractures and cysts, clinical and radiological outcomes, time to activity and complications were analyzed.

Results: Thirty-seven pediatric patients were included in this study. There were 18 patients in the non-internal fixation group and 19 patients in the internal fixation. There was no significant difference between these two groups in terms of age, duration of follow-up, fracture at diagnosis, cyst activity or healing time of pathological fractures and cysts. Cyst area in the internal fixation group was 1609±1131 mm², which was significantly greater than that in the group without internal fixation (936±597 mm², p<0.05). There was no significant difference in clinical or radiological outcomes between the two groups. Patients who were treated with internal fixation were able to return to activity significantly sooner than those who were not (5.9 months vs. 7.7 months; p<0.05). There was no significant difference in complications between the two groups (p=1.000).

Conclusions: Surgical treatment of proximal femoral UBCs in children remains a challenge. The use of internal fixation is beneficial for accelerating the healing process and reducing the time to activity.