A new technique for aneurysmal bone cysts of the proximal humerus: cortical collapsing

Objectives: We evaluated the results of a new technique developed for aneurysmal bone cysts centrally located in the proximal humeral metaphysis leading to widespread destruction. Methods: The study included seven patients (5 boys, 2 girls; mean age 12.8 years; range 9 to 15 years) who were treated with cortical collapsing and massive fibular au- tograft for centrally located aneurysmal bone cysts in the proximal humeral metaphysis leading to widespread de-struction. All the patients had type II and active tumors according to the criteria of Capanna et al. and Campanacci et al., respectively. Final evaluations included six patients because one patient was lost to follow-up. The mean fol¬low-up period was 49 months (range 12 to 105 months). Results: No complications were seen in the early postop¬erative period. Radiographic examination showed partial recurrence in two patients; of whom, one patient under¬went curettage and bone grafting in the postoperative sec¬ond year because of pain and discomfort. No deformity was observed. One patient developed shortening of 0.5 cm. Radiographically, all the patients exhibited metaphyseal remodelling one year after surgery. Function of the shoul¬der joint was near-normal in all the patients. Conclusion: In this technique, cortical collapsing reduces the amount of bone graft used, and massive fibular strut grafting provides structural support to prevent deformities.