Marginal excision and Ilizarov hemicallotasis for osteofibrous dysplasia of the tibia

Abstract

The surgical management of osteofibrous dysplasia (OFD), a rare developmental tumour-like condition of childhood that has a predilection for the tibia, ranges from curettage or subperiosteal resection to extraperiosteal wide resection followed by reconstruction. En-bloc excision followed by distraction osteogenesis has been described earlier for OFD. We describe a novel technique in which marginal excision was performed but instead of excising an entire segment of tibia, only the anterior portion containing the lesion was excised, sparing the uninvolved posterior cortex. Distraction osteogenesis was carried out on the anterior portion of the tibia (hemicallotasis) after acute correction of the deformity. Although the potential advantage is a decrease in time required for consolidation of the bone regenerate, this technique is dependent on the anatomical characteristics of the lesion. We describe a case in which this technique was adopted on a child with tibial OFD with resultant disease-free excision margins and deformity correction.