Selected Topics: Original ArticlePercutaneous Intramedullary Decompression, Curettage, and Grafting With Medical-Grade Calcium Sulfate Pellets for Unicameral Bone Cysts in Children: A New Minimally Invasive TechniqueDormans, John P MD; Sankar, Wudbhav N MD; Moroz, Leslie BA; Erol, Bülent MDAuthor Information From the Children's Hospital of Philadelphia, Philadelphia, PA. Study conducted at the Children's Hospital of Philadelphia, Philadelphia, PA. None of the authors received financial support for this study. Reprints: John P. Dormans, MD, Chief, Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Wood Building, 2nd Floor, 34th Street and Civic Center Blvd., Philadelphia, PA 19104 (e-mail: firstname.lastname@example.org). Journal of Pediatric Orthopaedics: November-December 2005 - Volume 25 - Issue 6 - p 804-811 doi: 10.1097/01.bpo.0000184647.03981.a5 Buy Metrics Abstract Several treatment options exist for unicameral bone cysts (UBCs), including observation, steroid injection, bone marrow injection, and curettage and bone grafting. These are all associated with high recurrence rates, persistence, and occasional complications. Newer techniques have been described, most with variable success and only short follow-up reported. Because of these factors, a new minimally invasive percutaneous technique was developed for the treatment of UBCs in children. Twenty-eight children with UBCs who underwent percutaneous intramedullary decompression, curettage, and grafting with medical-grade calcium sulfate (MGCS) pellets by the senior author (J.P.D.) between April 2000 and April 2003 were analyzed as part of a pediatric musculoskeletal tumor registry at a large tertiary children's hospital. Four patients were lost to follow-up, and the remaining 24 patients had an average follow-up of 21.9 months (range 4-48 months). Twelve patients were followed for at least 24 months. Six of the 24 children had received previous treatment of their UBC, most often at an outside institution. Follow-up was performed through clinical evaluation and radiographic review. Postoperative radiographs at most recent follow-up showed complete healing, defined as more than 95% opacification, in 22 of 24 patients (91.7%). One patient (4.2%) demonstrated partial healing, defined as 80% to 95% opacification. One patient had less than 80% radiographic healing (4.2%). All 24 patients returned to full activities and were asymptomatic at most recent follow-up. The only complication noted was a superficial suture abscess that occurred in one patient; this resolved with local treatment measures. The new minimally invasive technique of percutaneous intramedullary decompression, curettage, and grafting with MGCS pellets demonstrates favorable results with low complication and recurrence rates compared with conventional techniques. The role of intramedullary decompression as a part of this percutaneous technique is discussed. © 2005 Lippincott Williams & Wilkins, Inc.