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Fractured Aneurysmal Bone Cyst in Children – Is Conservative Treatment an Option?

Review Article | Volume 12 | Issue 2 | May-August 2026 | Page: 3-7 | Md Zafar Iqbal, Anil Agarwal, Sunny Bhalla

DOI- https://doi.org/10.13107/ijpo.2026.v12.i02.268

Open Access License: CC BY-NC 4.0

Copyright Statement: Copyright © 2026; The Author(s).

Submitted: 13/01/2026; Reviewed: 11/02/2026; Accepted: 03/06/2026; Published: 10/08/2026

Authors: Varun Garg [1], Anil Agarwal [2], Sunny Bhalla [2], Md Zafar Iqbal [2]

[1] Department of Orthopedics, All India Institute of Medical Sciences, Guwahati, Assam, India,
[2] Department of Pediatric Orthopedics, Chacha Nehru Bal Chikitsalya, New Delhi, India.

Address of Correspondence

Dr. Varun Garg,
Department of Orthopedics, All India Institute of Medical Sciences, Assam, Guwahati, India.
E-mail: varungarg9@gmail.com

Abstract

Objective: The objectives are to evaluate the outcomes of conservatively managed pathological fractures through aneurysmal bone cysts (ABCs) in children and to assess the potential for spontaneous cyst healing post-fracture.
Methods: A retrospective review was conducted of hospital records between January 2014 and October 2024. Children aged ≤14 years with fractured long bone ABCs and managed conservatively with at least 6 months of radiographic follow-up were included. Cases treated surgically or with recurrent/previously treated lesions were excluded. Radiographs were reviewed for lesion characteristics, Enneking staging, and radiographic features (loculation, cortical rim, tubulation, and bone scalloping). Outcomes were assessed using fracture union and cyst healing according to Rastogi’s criteria.
Results: Eight patients (6 males, 2 females; mean age 7.3 ± 3.2 years) met the inclusion criteria. The proximal humerus (n = 5) was the most frequently affected site, followed by the proximal femur (n = 2) and distal radius (n = 1). All lesions were metaphyseal and classified as Enneking stage II. At a mean follow-up of 7 ± 1.1 months, all fractures united radiologically. Partial cyst healing occurred in 3 patients (37.5%), while 5 patients (62.5%) showed no significant healing. No deformities or complications were reported.
Conclusion: Conservative management of pathological fractures through ABCs in children achieves fracture union and may induce partial cyst healing. Larger, multi-center studies are required to better define the predictors of healing after a fracture through the cyst.
Keywords: Aneurysmal bone cyst, pathological fracture, benign bone tumor, spontaneous healing, pediatric.

References

1. Batisse F, Schmitt A, Vendeuvre T, Herbreteau D, Bonnard C. Aneurysmal bone cyst: A 19-case series managed by percutaneous sclerotherapy. Orthop Traumatol Surg Res 2016;102:213-6.
2. Tsagozis P, Brosjö O. Current strategies for the treatment of aneurysmal bone cysts. Orthop Rev (Pavia) 2015;7:6182.
3. Noordin S, Ahmad T, Umer M, Allana S, Hilal K, Uddin N, et al. Aneurysmal bone cyst of the pelvis and extremities: Contemporary management. IJS Oncol 2019;4:e71.
4. Kaiser CL, Yeung CM, Raskin KA, Lozano-Calderon SA. Aneurysmal bone cyst of the clavicle: A series of 13 cases. J Shoulder Elbow Surg 2019;28:71-6.
5. Dormans JP, Hanna BG, Johnston DR, Khurana JS. Surgical treatment and recurrence rate of aneurysmal bone cysts in children. Clin Orthop Relat Res 2004;421:205-11.
6. Brosjö O, Pechon P, Hesla A, Tsagozis P, Bauer H. Sclerotherapy with polidocanol for treatment of aneurysmal bone cysts. Acta Orthop 2013;84:502-5.
7. Blackburn PR, Davila JI, Jackson RA, Fadra N, Atiq MA, Pitel BA, et al. RNA sequencing identifies a novel USP9X-USP6 promoter swap gene fusion in a primary aneurysmal bone cyst. Genes Chromosomes Cancer 2019;58:589-94.
8. Louahem D, Kouyoumdjian P, Ghanem I, Mazeau P, Perrochia H, L’Kaissi M, et al. Active aneurysmal bone cysts in children: Possible evolution after biopsy. J Children’s Orthop 2012;6:333-8.
9. McQueen MM, Chalmers J, Smith GD. Spontaneous healing of aneurysmal bone cysts. A report of two cases. J Bone Joint Surg Br 1985;67:310-2.
10. Cottalorda J, Bourelle S. Modern concepts of primary aneurysmal bone cyst. Arch Orthop Trauma Surg 2007;127:105-14.
11. Malghem J, Maldague B, Esselinckx W, Noel H, De Nayer P, Vincent A. Spontaneous healing of aneurysmal bone cysts. A report of three cases. J Bone Joint Surg Br 1989;71:645-50.
12. Costa DD, Gabrielli E, Cerrone M, Di Gialleonardo E, Maccauro G, Vitiello R. Pathological fractures in aneurysmal bone cysts: A systematic review. J Clin Med 2024;13:2485.
13. Deventer N, Deventer N, Gosheger G, De Vaal M, Vogt B, Budny T. Current strategies for the treatment of solitary and aneurysmal bone cysts: A review of the literature. J Bone Oncol 2021;30:100384.
14. Enneking WF, Spanier SS, Goodman MA. A system for the surgical staging of musculoskeletal sarcoma. Clin Orthop Relat Res 1980;153:106-20.
15. Cho S, Yankanah R, Babyn P, Stimec J, Doria AS, Stephens D, et al. Inter-rater reliability of the radiographic assessment of simple bone cysts. J Child Orthop 2019;13:226-35.
16. Rastogi S, Varshney MK, Trikha V, Khan SA, Choudhury B, Safaya R. Treatment of aneurysmal bone cysts with percutaneous sclerotherapy using polidocanol. A review of 72 cases with long-term follow-up. J Bone Joint Surg Br 2006;88:1212-6.
17. Ahmad S, Alam I, Khan AQ, Abbas MB, Chowdhry M. Polidocanol sclerotherapy for the treatment of aneurysmal bone cyst, with or without pathological fractures: A prospective, comparative study. J Orthop 2023;46:143-9.
18. Karaca MO, Bozkurt OE, Dursun Savran M, Özyıldıran M, Başarır K, Yıldız HY. Aneurysmal bone cysts (ABC): Retrospective analysis of two hundred and fifty eight cases. Int Orthop 2025;49:2207-17.
19. Cha SM, Shin HD, Kim KC, Park JW. Does fracture affect the healing time or frequency of recurrence in a simple bone cyst of the proximal femur? Clin Orthop Relat Res 2014;472:3166-76.
20. Deventer N, Deventer N, Gosheger G, De Vaal M, Budny T, Luebben T, et al. Evaluation of different treatment modalities for fractured and non-fractured simple bone cyst: A single-center review of 68 patients. Medicine (Baltimore) 2021;100:e26703.
21. Biesecker JL, Marcove RC, Huvos AG, Miké V. Aneurysmal bone cysts. A clinicopathologic study of 66 cases. Cancer 1970;26:615-25.

How to Cite this Article:  Garg V, Agarwal A, Bhalla S, Iqbal MZ | Fractured Aneurysmal Bone Cyst in Children – Is Conservative Treatment an Option? | International Journal of Paediatric Orthopaedics | May-August 2026; 12(2): 03-07.

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Iliopsoas Abscess in Children – A Forgotten Diagnosis

Volume 7 | Issue 2 | May-August 2021 | Page: 17-19 | Vinod Raj, Abhishek Chinya, Sanjay Sardessai, Jeevan Vernekar

Authors: Vinod Raj [1], Abhishek Chinya [1], Sanjay Sardessai [2], Jeevan Vernekar [2]

[1] Department of Paediatric Surgery, Goa Medical College and Hospital, Goa, India.
[2] Department of Radiology, Goa Medical College and Hospital, Goa, India

Address of Correspondence
Dr. Vinod Raj
Department of Paediatric Surgery, Goa Medical College and Hospital, NH 17, Bambolim, Tiswadi, North Goa,
Goa, India. 403202
E-mail: doc.vraj89@gmail.com

Abstract

Iliopsoas abscess is a rare diagnosis in children. We recently encountered two cases which were managed at our institution. A 11-year female presented with thigh and inguinal swelling while 3-year male child presented with limp and fixed flexion deformity of right leg. Due to the differing presentation, imaging studies are often important before management is planned. Ultrasound scan is the most common investigation followed by computerized tomography (CT) scan in a selected few. The girl underwent a CT scan followed by incision and drainage (I&D) of the iliopsoas abscess while the boy underwent ultrasound-guided pigtail catheter insertion. Both cases were successfully treated. Atypical presentation of iliopsoas abscess makes the diagnosis difficult and requires a high degree of clinical suspicion for making correct diagnosis. Imaging studies help with diagnosis in such cases. Less invasive techniques like image-guided aspiration and catheter drainage can be helpful in carefully selected cases.
Keywords: Iliopsoas abscess, Atypical presentation, Percutaneous drainage, Pediatric.

References

  1. Cronin CG, Lohan DG, Meehan CP, Delappe E, McLoughlin R, O’Sullivan GJ, et al. Anatomy, pathology, imaging and intervention of the iliopsoas muscle revisited. Vol. 15, Emergency Radiology. 2008. p. 295–310.
  2. Wong-Chung J, Bagali M, Kaneker S. Physical signs in pyomyositis presenting as a painful hip in children: A case report and review of the literature. Vol. 13, Journal of Pediatric Orthopaedics Part B. 2004. p. 211–3.
  3. Wang E, Ma L, Edmonds EW, Zhao Q, Zhang L, Ji S. Psoas abscess with associated septic arthritis of the hip in infants. J Pediatr Surg. 2010 Dec;45(12):2440–3.
  4. Elliott C. Paediatric Iliopsoas abscess: A case report. Australas J Ultrasound Med. 2013 Nov;16(4):198–201.
  5. Dietrich A, Vaccarezza H, Vaccaro CA. Iliopsoas abscess: Presentation, management, and outcomes. Surg Laparosc Endosc Percutaneous Tech. 2013 Feb;23(1):45–8.
  6. López VN, Ramos JM, Meseguer V, Pérez Arellano JL, Serrano R, Ordonez MAG, et al. Microbiology and outcome of iliopsoas abscess in 124 patients. Medicine (Baltimore). 2009 Mar;88(2):120–30.
  7. Zhou Y, Li G. Diagnosis and management of complicated intra-abdominal infection in adults and children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Chinese J Infect Chemother. 2010 Jul 20;10(4):241–7.
How to Cite this Article:  Raj V, Chinya A, Sardessai S, Vernekar J | Iliopsoas Abscess  in Children – A Forgotten Diagnosis | International Journal of Paediatric Orthopaedics | May-August 2021; 7(2): 17-19.

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