Case Report: Open Access
Lindsay et al. Int J Biol Instrum 2018, 1:001
Citation: Lindsay EA, Abbaschian CE, Copley LA (2018) Proximal Femoral Unicameral Cyst Resolved by Single Injection of
a Calcium Phosphate Bone Void Filler without Instrumentation. Int J Biol Instrum 1:001
Copyright: © 2018 Lindsay EA, et al. This is an open-access article distributed under the terms of the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and
source are credited.
*Corresponding author: Copley LA, University of Texas Southwestern, Children’s Health System of Texas, 1935
Medical District Drive, Dallas, USA, E-mail: LAWSON.COPLEY@childrens.com
Received: October 06, 2017: Accepted: January 30, 2018: Published: February 01, 2018
VIBGYOR
ISSN: 2631-5025
Proximal Femoral Unicameral Cyst Resolved by Single
Injection of a Calcium Phosphate Bone Void Filler without
Instrumentation
Lindsay EA, Abbaschian CE and Copley LA
*
University of Texas Southwestern, Children’s Health System of Texas, USA
Introduction
Unicameral Bone Cysts (UBC) are ofen identifed
incidentally as a consequence of pathologic fracture due
to insufciency of the skeletal architecture at the site of
involvement [1,2]. When the cyst involves long bones of
the lower extremity, treatment options are ofen dictated
by the occurrence of the fracture as well as the anticipa-
tion of the persistence of the cyst following fxation or
immobilization [3,4]. However, a UBC might occasion-
ally be identifed as an incidental fnding prior to frac-
ture. Treatment decision making therefore must take
into account the relative likelihood of impending patho-
logic fracture as well as the latent or active behavior of
the cyst [3,5,6]. Tis case report presents the rationale
and technical approach to the successful treatment of
a proximal femoral UBC in a young child with a single
injection of calcium phosphate bone void fller without
supplemental fxation.
Case Presentation
A four-year-old boy from China presented to a ter-
tiary pediatric medical center in the United States fol-
lowing the incidental fnding of a proximal femoral UBC
on plain radiographs. Approximately one year prior to
Abstract
Unicameral Bone Cysts (UBCs) of the proximal femur are commonly treated with supplemental
fxation to avoid the occurrence of pathologic fracture. Occasionally circumstances permit treatment
without the need for a more extensile approach with fxation. This case report illustrates successful
management of a proximal femoral UBC following a single injection of calcium phosphate bone void
fller without instrumentation.
presentation, he had a self-limited episode of limping
and pain in the lef hip and thigh with no history of trau-
ma. By the time the cyst was discovered the boy had no
symptoms and was unrestricted in all activities, includ-
ing aggressive play. Physicians in China recommended
open curettage and autologous bone grafing of the cyst
supplemented by internal fxation. Te family travelled
to the United States for a second opinion. Alternative
treatment options were reviewed with the family. Tese
included cyst injection with or without supplemental
fxation [3,7,8]. Te risks and benefts were discussed
with the family, including the potential need to cross the
proximal femoral growth plate with fxation which may
lead to growth arrest [7]. Te alternative of cyst injection
with a calcium phosphate bone void fller was consid-
ered in this case. Tese materials may be mixed in liq-
uid form and then solidify at body temperature into a
crystalline structure which resembles hydroxyapatite [9].
Biomechanical properties include an average compres-
sive strength of 26.5 ± 5.3 mega pascal (MPa) and tensile
strength of approximately 4.3 MPa [10]. Tis treatment
option was ofered in light of the child’s current absence
of symptoms, high level of activity, the latent appear-
ance of the cyst, and the assurance of the family that
they would be able to restrict the child from aggressive