Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 26, 2024; 12(6): 1130-1137
Published online Feb 26, 2024. doi: 10.12998/wjcc.v12.i6.1130
Simple bone cysts of the proximal humerus presented with limb length discrepancy: A case report
Cing Syue Lin, Shang Ming Lin, Syang-Peng Rwei, Chin-Wen Chen, Tsung-Yu Lan
Cing Syue Lin, Tsung-Yu Lan, Department of Orthopedic Surgery, Far Eastern Memorial Hospital, New Taipei City 220, Taiwan
Shang Ming Lin, Department of Materials and Textiles, Asia Eastern University of Science and Technology, New Taipei City 220, Taiwan
Syang-Peng Rwei, Chin-Wen Chen, Institute of Organic and Polymeric Materials, National Taipei University of Technology, Taipei City 10608, Taiwan
Author contributions: Lan TY, Lin SM, Rwei SP, and Chen CW contributed to conceptualization and supervision; Lin CS contributed to data collection, software, paper review, manuscript writing and editing; Lan TY contributed to clinical examination, surgery, original draft preparation and editing; All authors have read and agreed to the published version of the final manuscript.
Informed consent statement: Informed consent was obtained from the subject involved in the study. Written informed consent has been obtained from the patient to publish this paper.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Tsung-Yu Lan, Doctor, MD, Chief Doctor, Surgeon, Department of Orthopedic Surgery, Far Eastern Memorial Hospital, No. 21 Sec. 2, Nanya S. Road, Banciao District, New Taipei City 220, Taiwan.
Received: October 1, 2023
Peer-review started: October 1, 2023
First decision: January 2, 2024
Revised: January 10, 2024
Accepted: January 30, 2024
Article in press: January 30, 2024
Published online: February 26, 2024

Simple bone cysts (SBC) are benign tumor-like bone lesions typically identified in children. While SBC may lead to growth disturbances or growth arrest, such cases are uncommon. The mechanisms behind these observations remain unclear. Additionally, research on the etiology of SBC remains inconclusive, and there has been no consensus on the appropriate timing and methodology for treatment.


Here, we present our experience in the successful surgical management of a 10-year-old girl with SBC, who presented with a pathological fracture complicated by malunion of the displaced fracture, varus deformity, and limb length discrepancy. We hypothesized two possible etiologies for the patient’s growth arrest and subsequent humerus varus deformity: (1) Direct disruption of the physis by fluid from the cyst itself; and (2) damage to the epiphysis due to repetitive pathological fractures associated with SBC. In addressing this case, surgical intervention was undertaken to correct the proximal humerus varus deformity. This approach offered the advantages of simultaneously correcting angular abnormalities, achieving mild limb lengthening, providing definitive SBC treatment, and reducing the overall treatment duration.


As per current literature, acute correction of acute angular deformity in proximal humeral SBC is not well comprehended. However, in this specific case, acute correction was considered an optimal solution.

Keywords: Bone cyst, Solitary cysts, Benign, Humerus, Growth arrest, Limb length discrepancy, Case report

Core Tip: We successfully operated on a 10-year-old girl with simple bone cysts (SBC), who presented with varus deformity, limb length discrepancy, and malunion resulting from a neglected pathological fracture. We proposed two potential causes for the humeral growth arrest and varus deformity in this patient: (1) Direct disruption of the physis by fluid from the cyst itself; and (2) damage to the epiphysis due to recurrent pathological fractures associated with SBC. Presently, the literature lacks a comprehensive understanding of the acute correction of angular deformity in proximal humeral SBC. However, in this specific case, acute correction was considered an ideal option.