Are osseous cyst‐like lesions in the subchondral bone of the proximal phalanx a precursor to fracture and how are they best managed?

Abstract

SummaryOsseous cyst‐like lesions (OCLL) in the proximal subchondral bone of the proximal phalanx have been seen in association with fractures of the proximal phalanx and other bone abnormalities consistent with prodromal fracture pathology. There is reasonable circumstantial evidence to support that OCLL in this location can be a precursor to fracture. Repair of short incomplete sagittal fractures of the proximal phalanx with cortical bone screws placed in lag fashion has been associated with good clinical and variable radiographic outcomes. Stabilisation of OCLL by placement of a cortical screw in lag fashion appears a logical approach, but the outcome following surgery should be critically evaluated before a wider recommendation is made.