Aneurysmal bone cysts of the clavicle: a comparison of extended curettage and segmental resection with bone reconstruction

Background: Although curettage of an aneurysmal bone cyst (ABC) of the clavicle has a high rate of local recurrence, segmental resection is often avoided for treatment as it causes functional impairment and shoulder deformity. We evaluated the rate of local recurrence and functional outcomes of extended curettage vs. segmental resection with bone reconstruction for the treatment of clavicular ABC. Methods: A total of 14 patients with clavicular ABC were studied. Extended curettage and segmental resection with bone reconstruction were done for 6 and 8 patients, respectively. The number of local recurrences and postoperative complications was recorded for each group. The function of the shoulder was assessed using the Constant-Murley score. Results: The mean age of the patients was 26.2 +/- 14.7 years (range, 4-56 years). At a mean follow-up of 60 +/- 37.6 months, 2 recurrences developed, both in the curettage group. Two postoperative complications (1 infection and 1 nonunion) were also recorded, both in the segmental resection group. The mean Constant-Murley score was 88.2 +/- 3.4 in the extended curettage group and 87.3 +/- 2.4 in the segmental resection group (P = .85). Conclusions: Considering the comparable function of the shoulder in curettage and segmental resection with bone reconstruction in clavicular ABC, we recommend the latter approach because of the lower recurrence rate, albeit with a higher rate of potential complications. (C) 2019 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.