Ossoscopy – a treatment method for juvenile bone cysts of the calcaneus

Sa？etak Juvenile bone cysts (JBCs) are benign bone lesions that occur in children. Calcaneus is the third most frequent location in the body where they may present. More than 60% of JBCs of the calcaneus are asymptomatic, and when they become symptomatic, they usually cause pain, tenderness on palpation and occasional local swelling. Decision on managing JBC of the calcaneus is based on the size of the cyst and patient’s symptoms. The critical size of calcaneal JBC is defined when the cyst affects 100% of the intracalcaneal cross section in the coronary plane and at least 30% in the sagittal plane. Cysts of this size tend to become symptomatic and have an increased risk of developing a pathological fracture, therefore, it is advised to manage those cysts surgically. The most frequently used management approach for JBCs of the calcaneus is open curettage combined with augmentation using autograft or allograft bone transplantation. However, endoscopic method is nowadays considered as effective as the open approach. Because this endoscopic method is performed inside the bone cavity, it is called ‘ossoscopy’. A 14-year-old boy was diagnosed with a JBC in the calcaneus which affected the whole intracalcaneal cross section both in coronary and transverse planes, as well as more than 30% of the intracalcaneal cross section in the sagittal plane. Curettage of the cyst was performed ossoscopically, combined with augmentation using allograft bone transplant. The operative technique performed is described in this article together with a literature review evaluating this technique in comparison with other surgical techniques for the management of calcaneal JBCs