Although studied for more than a century, the cause of unicameral bone cyst (UBC) remains uncertain. UBC of the pelvis in younger patients has been particularly problematic because its rarity often results in misdiagnosis and improper treatment. Surgical treatment has typically involved percutaneous or open curettage and bone grafting; however, some studies have described the use of a continuous decompression device to address high recurrence rates of the lesion. We present a 13-year-old male patient in whom, after two unsuccessful operations, open curettage and grafting and insertion of a cannulated screw led to resolution of pain caused by a large, recurrent UBC in the left ilium. Results of clinical examinations 1.5 years after the third operation indicated successful treatment. The use of a cannulated screw after open curettage and grafting may provide a clinically effective option for treating UBC.

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