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Daniel Gonzales-Luna, MD (PGY4) presents the #interestingcase of 7 y.o. male with a history of multiple (5) pathologic fractures to the (L) proximal #humerus over the last 2 yrs. He presents with (L) shoulder pain for 3 wks for a 2nd opinion
Pt. has been treated with immobilization and observation in the past resulting in periods of painless activity followed by recurrence of #fracture what would you do?
Radiographs show a large lytic metaphyseal lesion adjacent to the physis in the (L) proximal humerus with a pathologic fracture involving the lateral cortex. Pre Op AP
Pre Op Lateral
Left proximal humerus with anterior cortical window 6 cm in length
#Cryotherapy using liquid nitrogen
Cortical fibular allograft cut into 6 thin segments and placed as intramedullary struts
Void filled with crushed cancellous autograft
3 month follow up. Pt. with painless range of motion. Cleared for full activity
Biopsy consistent with unicameral bone cyst
