Simple cysts of the humerus treated by radical excision.

A simple bone cyst in the upper end of the humerus presents a common surgical problem. lt is usually diagnosed in childhood or adolescence because of a pathological fracture. Rarely the cyst heals after fracture; usually it persists and needs surgical treatment if the risk of recurrent fractures is to be avoided. Curettage of the cyst and packing of the cavity with bone chips is the usual treatment; this may be successful, but often the cyst recurs so that repeated operations are needed. Recurrence is attributed to incomplete removal of the membrane lining the cyst. Our operation consists of subperiosteal excision of the whole of the cyst-bearing part of the diaphysis, which includes removal of all the membrane lining the cyst. The case histories of three patients reported here show that radical operation can be performed with no greater inconvenience to the patient than the less certain procedure of curettage.