Unicameral bone cysts: a comprehensive review of epidemiology, diagnosis, and evidence-based managements

Unicameral bone cysts (UBCs) are cystic, lytic lesions, most commonly found in the long bones of children and adolescents. They are usually asymptomatic and discovered incidentally, but they are related to an increased risk of pathological fractures. Management of UBCs is debated and ranges from careful observation to various surgical interventions. As the lesion may resolve spontaneously, care must be taken to reduce the risk of complications while avoiding unnecessary invasive interventions. This article aims to narratively compile and evaluate the present evidence regarding the understanding, challenges, and controversies surrounding the diagnosis and management of UBCs, and to provide valuable insights into the different diagnostic and therapeutic strategies available for these lesions. The diagnosis and management of UBCs remains a subject of considerable debate between advocates of conservative management and proponents of surgical intervention. Recent developments have emphasized cyst decompression and fracture prevention, often through fixation. However, these interventions are not without risks of failure or complications. Therefore, physicians need to tailor an appropriate management plan that considers the patient’s specific clinical and radiological findings and preferences.