β£Description of SBC/ UBCSkeletally immature!L: Meta-diaphyseal (starts in metaphysis β diaphysis), centralA: lytic, fallen leaf signR: narrow zone, no periosteal reactionM: scleroticβ£What is a fallen leaf sign?pathologic fracture with fallen cortical fragment in base of empty cystβ£Management of SBC?Mostly conservative. 15% fill up with bone as child maturesMethylprednisolone injection [if painful]Success rate 30-70%Usually requires several injectionβ£Management of SBC associated fracture?Upper limb - can treat conservatively until fracture heals as cyst will fill up with new bone in 15%β£Indications for surgery?Lower limb fractures (Including impending)Symptomatic latent cysts (recurrent UL fractures/pain) that have not responded to steroid injectionsβ£How does TENS nail work in SBC?Theory is that inserted nail will allow continuous decompression of the lesion and decrease in intralesional pressureJBJS 2000: Flexible Intramedullary Nailing for the Treatment of Unicameral Bone Cysts in Long Bonesβ£What does this slide show in terms of progression of the SBC?SBC from active (next to physis) to becoming latent (away from physis)