Comparative Clinical Study of Corticosteroid versus Autologous Bone Marrow Injection Combined with Elastic Stable Intramedullary Nailing for Pediatric Long-Bone Unicameral Bone Cyst

DU Yingjie; YAO Jiaqi; LIU Li; DENG Xiangling; LI Wenchao

doi:10.3969/j.issn.1004-3594.2026.06.006

PDF(2611 KB)

Medical Journal of the Chinese People Armed Police Forces ›› 2026, Vol. 37 ›› Issue (6) : 491-496. DOI: 10.3969/j.issn.1004-3594.2026.06.006

ORIGINAL ARTICLES

Comparative Clinical Study of Corticosteroid versus Autologous Bone Marrow Injection Combined with Elastic Stable Intramedullary Nailing for Pediatric Long-Bone Unicameral Bone Cyst

DU Yingjie¹, YAO Jiaqi¹, LIU Li², DENG Xiangling², LI Wenchao²

Author information +

History +

Abstract

Objective To compare the efficacy and safety of elastic stable intramedullary nailing (ESIN) combined with corticosteroid versus combined with autologous bone marrow (ABM) injection in the treatment of unicameral bone cyst (UBC) in the long bones of children. Methods A retrospective analysis was performed on 45 children with UBC admitted to the First and the Seventh Medical Centers of the PLA General Hospital from January 2015 to December 2023. The patients were divided into group A (n=21, ESIN plus corticosteroid) and group B (n=24, ESIN plus ABM injection). Postoperative imaging follow-up was performed regularly, and cyst healing was evaluated according to the Capanna criteria. Results All the 45 patients completed follow-up, with a mean follow-up duration of 40.4 months. The overall effective rate was 90.5% (19/21) in group A and 91.7% (22/24) in group B, with no statistically significant difference between the two groups (P=0.89). Among the 45 cases, 28 (62.2%) achieved complete healing, 13(28.9%) had partial healing, 2(4.4%) developed recurrence, and 2(4.4%) showed no response to treatment. Conclusions Both ESIN combined with corticosteroid and ESIN combined with ABM injection are safe and effective minimally invasive methods for the treatment of UBC.

Key words

unicameral bone cyst / children / elastic intramedullary nailing / corticosteroid / autologous bone marrow

Cite this article

EndNote

Ris (Procite)

Bibtex

Download Citations

DU Yingjie, YAO Jiaqi, LIU Li, DENG Xiangling, LI Wenchao. Comparative Clinical Study of Corticosteroid versus Autologous Bone Marrow Injection Combined with Elastic Stable Intramedullary Nailing for Pediatric Long-Bone Unicameral Bone Cyst[J]. Medical Journal of the Chinese People Armed Police Forces. 2026, 37(6): 491-496 https://doi.org/10.3969/j.issn.1004-3594.2026.06.006

References

[1] Rajasekaran R B, Krishnamoorthy V, Gulia A.Unicameral bone cysts:review of etiopathogenesis and current concepts in diagnosis and management[J].Indian J Orthop,2022,56(5):741-751.
[2] Aycan O E, Çamurcu Y, Özer D, et al.Unusual localizations of unicameral bone cysts and aneurysmal bone cysts:a retrospective review of 451 cases[J].Acta Orthop Belg,2015,81(2):209-212.
[3] Döring K, Sturz G D, Hobusch G, et al.Open surgical treatment of unicameral bone cysts:a retrospective data analysis[J].Wien Klin Wochenschr,2024,136(19-20):547-555.
[4] Li J,Rai S,Ze R,et al.Injectable calcium sulfate vs mixed bone graft of autologous iliac bone and allogeneic bone:which is the better bone graft material for unicameral bone cyst in humerus?[J].Medicine (Baltimore),2020, 99(23):e20563.
[5] 张逸凡,黄永波.儿童单纯性骨囊肿治疗研究进展[J].中国骨科学杂志,2025,46(3):165-168.
[6] D’amato R D, Memeo A, Fusini F,et al.Treatment of simple bone cyst with bone marrow concentrate and equine-derived demineralized bone matrix injection versus methylprednisolone acetate injections:a retrospective comparative study[J].Acta Orthop Traumatol Turc,2020,54(1):49-58.
[7] Fauzi Kamal A, Ajiantoro A, Prabowo Y.Simple bone cyst treated with percutaneous steroid injection[J]. Asian J Pharm Sci,2018,11(5):180-196.
[8] 张科学,丑小冰,李浩宇.自体骨髓血注射结合弹性髓内针治疗儿童长骨骨囊肿[J].中国骨伤,2019,32(5):475-478.
[9] 张炜剑,毛瑞君,黄峰,等.自体髂骨移植治疗髌骨动脉瘤性骨囊肿1例[J].中国骨与关节损伤杂志,2017, 32(4):375.
[10] 徐涛涛,李论,吕敏捷,等.弹性髓内钉联合骨替代物治疗儿童股骨近端单纯性骨囊肿的疗效[J].武汉大学学报(医学版),2025,46(12):1621-1626.
[11] Deventer N,Deventer N,Gosheger G,et al.Evaluation of different treatment modalities for fractured and non-fractured simple bone cyst:a single-center review of 68 patients[J].Medicine(Baltimore),2021,100(31):e26703.
[12] Canavese F,Wright J G,Cole W G,et al.Unicameral bone cysts:comparison of percutaneous curettage, steroid, and autologous bone marrow injections[J].J Pediatr Orthop,2011,31(1):50-55.
[13] Zhou J,Ning S,Su Y,et al.Elastic intramedullary nailing combined with methylprednisolone acetate injection for treatment of unicameral bone cysts in children:a retrospective study[J].J Child Orthop,2021,15(1):55-62.
[14] Erol B,Onay T,Topkar O M,et al.A comparative study for the treatment of simple bone cysts of the humerus:open curettage and bone grafting either without instrumentation or with intramedullary nailing[J].J Pediatr Orthop B,2017,26(1):5-13.
[15] Toepfer A,Strässle M,Lenze U,et al.Allogenic cancellous bone versus injectable bone substitute for endoscopic treatment of simple bone cyst and intraosseous lipoma of the calcaneus and is intraosseous lipoma a developmental stage of a simple bone cyst?[J].J Clin Med,2023,12(13):437-446.
[16] Zhang K X,Chai W,Zhao J J,et al.Comparison of three treatment methods for simple bone cyst in children[J]. BMC Musculoskelet Disord,2021,22(1):73.
[17] Zhang P,Zhu N,Du L,et al.Treatment of simple bone cysts of the humerus by intramedullary nailing and steroid injection[J].BMC Musculoskelet Disord,2020,21(1):70.
[18] 张科学,丑小冰,李浩宇,等.弹性髓内针与自体骨髓血注射治疗儿童骨囊肿的疗效对比研究[J].中国骨伤, 2019,32(12):1112-1116.
[19] Zhao J G,Wang J,Huang W J,et al.Interventions for treating simple bone cysts in the long bones of children[J]. Cochrane Database Syst Rev,2017,2(2):CD010847.
[20] Farr S,Balaco I M S,Martinez A S,et al.Current trends and variations in the treatment of unicameral bone cysts of the humerus:a survey of EPOS and POSNA members[J].J Pediatr Orthop,2020,40(1):e68-e76.
[21] Geloven T P,Der H L,Laitinen M K,et al.As simple as it sounds? The treatment of simple bone cysts in the proximal femur in children and adolescents:retrospective multicenter EPOS study of 74 patients[J].J Child Orthop, 2024,18(1):85-95.
[22] Chang C H,Stanton R P,Glutting J.Unicameral bone cysts treated by injection of bone marrow or methylprednisolone[J].J Bone Joint Surg Br,2002,84(3):407-412.
[23] Cho H S,Oh J H,Kim H S,et al.Unicameral bone cysts:a comparison of injection of steroid and grafting with autologous bone marrow[J].J Bone Joint Surg Br,2007,89(2):222-226.
[24] Wang Y,Ren X,Yang D,et al.Risk factors for pathological fractures of simple bone cysts of the humerus in children:a retrospective cohort study[J].Transl Pediatr,2022,11(7):1261-1266.
[25] Pala E,Trovarelli G,Angelini A,et al.Modern treatment of unicameral and aneurysmatic bone cysts[J]. EFORT Open Rev,2024,9(5):387-392.
[26] Liu J,Su Y.Factors which can influence elastic stable intramedullary nailing removal in healed bone cysts in children[J].Sci Rep,2024,14(1):11129.
[27] Wang X,Han J,Li Y,et al.Comparative efficacy and safety profile for the treatment of humeral bone cysts in children:curettage and mixed bone grafting either with or without elastic intramedullary nailing[J].J Orthop Surg Res,2021,16(1):241.
[28] Ge J,Tian K.Management strategies and outcomes of pediatric unicameral bone cyst:a narrative review[J]. Front Pediatr,2026,14:1753597.
[29] Zhou L,Jiang Z,Zhang Z,et al.Minimally invasive endoscopic treatment for unicameral bone cysts:technique and outcomes in a series of 33 pediatric and adolescent patients[J].J Orthop Surg Res,2025,21(1):45.
[30] 周建武,宁尚坤,刘传康.糖皮质激素注射联合弹性钢针固定治疗股骨近端单纯骨囊肿的初步观察[J].临床小儿外科杂志,2019(1):25-29.
[31] Gholami F M S,Mohammadi A,Javadi M,et al.Bone marrow mesenchymal stem cells’ osteogenic potential:superiority or non-superiority to other sources of mesenchymal stem cells?[J].Cell Tissue Bank,2023,24(3):663-681.
[32] Soltan M,Smiler D,Choi J H.Bone marrow:orchestrated cells, cytokines,and growth factors for bone regeneration[J].Implant Dent,2009,18(2):132-141.
[33] Tomasian A,Jennings J W.Bone marrow aspiration and biopsy:techniques and practice implications[J].Skeletal Radiol,2022,51(1):81-88.