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Unicameral bone cyst of the lunate in an adult: case report.

Gündeş H, Sahin M, Alici T - J Orthop Surg Res (2010)

Bottom Line: We report a case of a symptomatic unicameral (simple) bone cyst of the lunate in a 42-year- old woman.At five years of follow-up the wrist was pain free, there were no limitations of motion, and the radiographs showed complete obliteration of the cavity.To the best of our knowledge, no other unicameral bone cyst of the lunate has been reported in an adult.

View Article: PubMed Central - HTML - PubMed

Affiliation: Maltepe University, School of Medicine, Department of orthopedics and hand surgery, Istanbul, Turkey. hakangundes@yahoo.com.

ABSTRACT
We report a case of a symptomatic unicameral (simple) bone cyst of the lunate in a 42-year- old woman. The lesion was treated with curettage and cancellous autogenous iliac bone grafting. At five years of follow-up the wrist was pain free, there were no limitations of motion, and the radiographs showed complete obliteration of the cavity. To the best of our knowledge, no other unicameral bone cyst of the lunate has been reported in an adult. Cysts with significant cavities at the carpal bones in an adult should be approached cautiously, as they may require early curettage and bone grafting for healing, before collapse and degenerative changes occur.

No MeSH data available.


Related in: MedlinePlus

A radiograph taken five years after the operation showed solid incorporation of the graft, and complete obliteration of the cavity.
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Figure 4: A radiograph taken five years after the operation showed solid incorporation of the graft, and complete obliteration of the cavity.

Mentions: A dorsal longitudinal incision of 6 cm was made on the ulnar side of the Lister's tubercle, extending proximally and distally through the skin and subcutaneous tissue. The extensor retinaculum was sectioned between the third and fourth compartments, parallel to the incision. The third and fourth compartments were connected. Tendons were retracted and the capsule was exposed. The capsule was cut open through an H-shaped incision, allowing the evaluation of the proximal part of the capitate and the lunate fossa. Curettage was performed by opening a dorsal 3 mm cortical window through the cartilage. After the fluid was aspirated, the fibrous membrane-like tissue lining the cyst wall was curetted, and a power burr was not used. The cyst was packed with cancellous autogenous iliac bone chips. We preferred to utilize autogenous iliac bone over distal radius in order to increase the chance of incorporation [1]. The wrist was protected with a well padded splint for two weeks to alleviate the pain and discomfort. After that, active and passive range of motion exercises and strengthening had been instituted. The histopathological diagnosis was unicameral bone cyst. A radiograph that had been taken two years after the operation showed solid incorporation of the graft. At five years of follow-up, the wrist was pain free, there were no limitations of motion observed, and the radiograph showed complete obliteration of the cavity (Figure 4).


Unicameral bone cyst of the lunate in an adult: case report.

Gündeş H, Sahin M, Alici T - J Orthop Surg Res (2010)

A radiograph taken five years after the operation showed solid incorporation of the graft, and complete obliteration of the cavity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2984580&req=5

Figure 4: A radiograph taken five years after the operation showed solid incorporation of the graft, and complete obliteration of the cavity.
Mentions: A dorsal longitudinal incision of 6 cm was made on the ulnar side of the Lister's tubercle, extending proximally and distally through the skin and subcutaneous tissue. The extensor retinaculum was sectioned between the third and fourth compartments, parallel to the incision. The third and fourth compartments were connected. Tendons were retracted and the capsule was exposed. The capsule was cut open through an H-shaped incision, allowing the evaluation of the proximal part of the capitate and the lunate fossa. Curettage was performed by opening a dorsal 3 mm cortical window through the cartilage. After the fluid was aspirated, the fibrous membrane-like tissue lining the cyst wall was curetted, and a power burr was not used. The cyst was packed with cancellous autogenous iliac bone chips. We preferred to utilize autogenous iliac bone over distal radius in order to increase the chance of incorporation [1]. The wrist was protected with a well padded splint for two weeks to alleviate the pain and discomfort. After that, active and passive range of motion exercises and strengthening had been instituted. The histopathological diagnosis was unicameral bone cyst. A radiograph that had been taken two years after the operation showed solid incorporation of the graft. At five years of follow-up, the wrist was pain free, there were no limitations of motion observed, and the radiograph showed complete obliteration of the cavity (Figure 4).

Bottom Line: We report a case of a symptomatic unicameral (simple) bone cyst of the lunate in a 42-year- old woman.At five years of follow-up the wrist was pain free, there were no limitations of motion, and the radiographs showed complete obliteration of the cavity.To the best of our knowledge, no other unicameral bone cyst of the lunate has been reported in an adult.

View Article: PubMed Central - HTML - PubMed

Affiliation: Maltepe University, School of Medicine, Department of orthopedics and hand surgery, Istanbul, Turkey. hakangundes@yahoo.com.

ABSTRACT
We report a case of a symptomatic unicameral (simple) bone cyst of the lunate in a 42-year- old woman. The lesion was treated with curettage and cancellous autogenous iliac bone grafting. At five years of follow-up the wrist was pain free, there were no limitations of motion, and the radiographs showed complete obliteration of the cavity. To the best of our knowledge, no other unicameral bone cyst of the lunate has been reported in an adult. Cysts with significant cavities at the carpal bones in an adult should be approached cautiously, as they may require early curettage and bone grafting for healing, before collapse and degenerative changes occur.

No MeSH data available.


Related in: MedlinePlus