| Objective:To investigate the result of healing solitary bone cysts by steroid injection, hollow nail or subtotal resection plus bone grafting and to discuss the infect-ive factors of treatment failure.Methods:We performed a research of operative reports at the Second Affiliated Hospital Zhejiang University College of Medicine to identify 61 patients who were surgically treated for unicameral bone cysts in the humerus,femur or tibia between 2001 and 2006.They received one of the three study treatments and had sufficient followup to determine whether they had a treatment failure.There were 14 patients treated with percutaneous steroid injection(steroids) while 17 patients were treated with hollow nail and 30 ones with subtotal resection plus bone grafting.The result of radiographic inspection after injection and the functional evaluation had been retrospect-ive analyzed.Results:61 patients were all followed up with 18 months to 72 months.The mean followup was 36 months.There were 49 patients successfully treated completely after 8 to 16 months.The total failure rate was 19.7%after one treatment.35.7%of cysts treated with steroids experienced failed treatment versus 23.5%with hollow nails and 10%with subtotal resection.The results are significant.Conclusion:When treating UBCs,we should consider the size of the cyst,wall thickness,percentage of cyst resolution and its anatomical position.It is better for UBCs who present with pathologic fracture to be treated with conservative methods first. Subtotal resection is the best treatment,steroid injection is the worst one.We believe subtotal resection plus bone grafting is a reasonable first treatment for unicameral bone cysts which present with pathologic fracture or need for retreatment.Statistical analysis indicated the choice of treatment and younger age were independent predictors of failure.
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