UNICAMERAL BONE-CYST OF THE CALCANEUS IN CHILDREN

The calcaneus is an uncommon site for a unicameral bone cyst. However, because of the concentration of forces through the heel, such cysts a re usually symptomatic and require treatment. Because of the lack of a ttention paid to calcaneal unicameral bone cysts, as well as the contr oversy concerning their appropriate treatment and ultimate outcome, a retrospective study of our experience was undertaken. Over a 15-year p eriod, we treated six children with calcaneal unicameral bone cysts. T he diagnosis was confirmed pathologically at the time of treatment for all six. The most common presenting complaint was heel pain upon weig ht-bearing, secondary to microfracturing of the cyst. Although conserv ative treatment, which entailed casting and sponge fillers in the shoe s, was attempted for most patients, none responded to this form of man agement. One child had three separate injections of methylprednisolone acetate without any radiographic or clinical change in the cyst, whic h ultimately required curettage and bone grafting. Bone grafting with either autogenous or allograft bone was successful in eradicating the cyst in all six patients, with no symptoms of recurrence at an average follow-up of 4 years. No resultant treatment complications were encou ntered. Unicameral bone cysts of the calcaneus, when symptomatic, resp ond well to curettage and bone grafting, and this type of treatment is recommended.