‣Description of SBC/ UBCSkeletally immature!L: Meta-diaphyseal (starts in metaphysis ➔ diaphysis), centralA: lytic, fallen leaf signR: narrow zone, no periosteal reactionM: sclerotic‣What is a fallen leaf sign?pathologic fracture with fallen cortical fragment in base of empty cyst‣Management of SBC?Mostly conservative. 15% fill up with bone as child maturesMethylprednisolone injection [if painful]Success rate 30-70%Usually requires several injection‣Management of SBC associated fracture?Upper limb - can treat conservatively until fracture heals as cyst will fill up with new bone in 15%‣Indications for surgery?Lower limb fractures (Including impending)Symptomatic latent cysts (recurrent UL fractures/pain) that have not responded to steroid injections‣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 Bones‣What does this slide show in terms of progression of the SBC?SBC from active (next to physis) to becoming latent (away from physis)