Traumatic bone cyst, also known as simple bone cyst, is a relatively common lesion found in the long bones and jaws. According to Brad Neville's "Oral and Maxillofacial Pathology," the traumatic bone cyst is "a benign, empty, or fluid-containing cavity within bone that is devoid of an epithelial lining." Although a definitive cause has not been established for this lesion, the traumatic bone cyst is believed to occur as a result of trauma to the bone, which leads to bleeding within the bone. If the hemorrhage does not repair and organize itself, an empty cavity, or traumatic bone cyst, remains. One main course of treatment exists, but alternative treatments have also been explored.
Surgical Exploration
This is the treatment of choice for the traumatic bone cyst. Surgical exploration, sometimes accompanied by scraping of the walls of the lesion, serves the dual purpose of confirming the diagnosis of traumatic bone cyst and acting as a method of treatment. Surgical manipulation of the lesion results in the previously empty cavity filling with blood. Soft tissue of the surgical incision is allowed to heal completely, and no other treatment is usually needed. Bone soon fills in the defect.
Intralesional Steroid Injections
An alternative treatment is to inject 80 to 200 mg of methylprednisone into the cystic cavity. According to Neville, steroid treatment is reserved for aggressive lesions of the long bones. These injections must often be repeated several times, and a 1997 study referenced in Emedicine Radiology shows healing to be unpredictable.
No Treatment
Traumatic bone cysts are usually asymptomatic unless a fracture occurs near the cyst. It is possible to avoid treatment as long as bone surrounding the cyst remains intact. Also, some traumatic bone cysts will heal spontaneously without treatment.
References
- "Oral and Maxillofacial Pathology, 3rd Edition"; Neville, Brad; 2001
- Emedicine Radiology: Simple Bone Cyst
- Wheeless' Textbook of Orthopaedics: Simple Bone Cyst (Unicameral)
