Fibrous Dysplasia Of Proximal Femur Research Articles

Muscle function around the hip after operation for Fibrous Dysplasia of Proximal Femur with Varus Deformity.

This study aimed to analyse the clinical effect of surgery for patients with fibrous dysplasia (FD) of the proximal femur with varus deformity, detect the muscle function around the hip joint. This is a retrospective study. A total of 20 patients who underwent operation for FD of the proximal femur with varus deformity at West China Hospital, from January 2018 to October 2022 were included in this study. The peak torque (PT) of muscle strength during abduction, adduction, flexion and extension of bilateral hip joints was measured by an isokinetic muscle test and training system associated with the comparison of bilateral hip joints, to evaluate the function of muscles around the hip joint after operation. The difference between the length of the affected limb and the healthy side was 1~2 cm in seven cases and <1 cm in 13 cases. The force line showed no abnormality in 15 affected limbs, which deviated from the center of the knee joint by 3-5 mm in five cases. The average PT during abduction of hip joints on the affected side of 20 patients was significantly lower than that on the healthy side, which was also reduced evidently during adduction and flexion of hip joints on the affected side compared with that on the healthy side. After effective recovery of the force line and length of the affected limb in patients with FD of the proximal femur with deformity, functional abnormalities of muscles are still present to a certain extent.

Functional outcome in surgical fixation of fibrous dysplasia of proximal femur

&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Background:&lt;/span&gt;&lt;/strong&gt;&lt;span lang="EN-US"&gt; Fibrous dysplasia is a rare benign intramedullary fibro-osseous lesion. Surgical management is usually indicated in pathological fractures, symptomatic patients due to pain and due to deformity. The aim of this study was to summarize the functional results and to investigate surgical treatment methods by conducting a retrospective study of patients with fibrous dysplasia (FD) in the proximal femur.&lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Methods:&lt;/span&gt;&lt;/strong&gt;&lt;span lang="EN-US"&gt; This study is a retrospective study using patient’s medical records, including analysis of 14 patients with fibrous dysplasia of proximal femur treated at Nizams Institute of Medical Sciences. The primary outcome was success of the procedure according to the Musculoskeletal tumour society score (MSTS). Secondary outcomes, which were assessed at one year and at the end of follow up in terms of revision free survival and change in femoral neck-shaft angle over time. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Results:&lt;/span&gt;&lt;/strong&gt;&lt;span lang="EN-US"&gt; Analysis of data showed that revision-free survival was 85% after a median follow-up of 2 years. Revision was necessary in one patient for structural failure due to a fracture distal to Dynamic hip screw and other patient due to progressive deformity after being operated with broad DCP. At the end of follow-up 85% of all patients had good walking ability and all patient were pain free. &lt;/span&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Conclusions:&lt;/span&gt;&lt;/strong&gt;&lt;span lang="EN-US"&gt; Symptomatic fibrous dysplasia involving proximal femur needs to be operated to relieve pain due to biomechanical instability, to prevent and treat pathological fractures and to correct deformities.&lt;/span&gt;&lt;/p&gt;

Surgical Treatment Modalities in Pediatric Monostotic Fibrous Dysplasia of Proximal Femur - A Case Series.

Monostotic fibrous dysplasia is a rare genetic non-inherited orthopedic condition presenting at any age with variable presentation. Proximal femur being the most common site, the mechanical factor predisposes it to increased chances of pathological fracture, which makes it challenging to choose an appropriate treatment modality and implant selection in children. In this retrospective case series, six children aged 7-12 years with monostotic fibrous dysplasia with or without fracture were treated with different treatment modalities from 2015 to 2020. Extended curettage and bone grafting and stabilization were done with extramedullary implants such as locking plates and DHS. Autograft alone or combination with allograft was chosen according to size of lesion. Patients without fracture were treated with curettage and artificial bone graft substitute with hip spica. Patients were followed up to 12 months. Revised Musculoskeletal Tumor Society (MSTS) score at each follow-up and Toronto Extremity Salvage Score (TESS) at final follow-up. Mean fracture healing time was 14.8 ± 2.28 weeks. in patients with fracture. Full weight-bearing was started at average 15.67 ± 2.94 weeks. One patient had shortening of 1 cm but none had any surgical site infection, loss of correction, or varus collapse more than 5°. Mean revised MSTS at 12 months was 24.2 ± 2.28 in patients with curettage, bone grafting, and internal fixation, while it was 27 in patients with curettage, grafting with hip spica. Mean TESS was found to be 90 ± 9.41 in internal fixation group, while it was 95 in patient with curettage, grafting with hip spica. Treatment modality should be chosen wisely after analyzing pre-operative radiograph, lesion size, presence of pathological fracture, and each patient profile. Extramedullary fixation devices can be an alternate choice of implant in children and adolescents for monostotic fibrous dysplasia. Long duration follow-up and patient counseling should be done for recurrence of lesion and deformities.

Prevention of pathological fracture in fibrous dysplasia of proximal femur in a 24-year-old female a rare presentation - a case report

&lt;p class="abstract"&gt;Fibrous dysplasia (FD) was historically mentioned in the medical literature in 1938 by Dr. Lichtenstein and in 1942 by Dr. Lichtenstein and Jaffe. The term Jaffe-Lichtenstein syndrome is sometimes used synonymously with monostotic FD or to denote cases of polyostotic FD with café au lait spots, but no endocrine dysfunction. Our case is a 24-year-old female, housewife presented to our hospital with a complaints of right hip pain and backache with difficulty in walking of 6 months duration. She had dull aching pain which increased in intensity with the course of time, there was no radiation, but was aggravated by movements. She was managed with dynamic hip screw along with curettage of the lesion and bone graft, after 9 months of follow up, she had no pain over her hip and there was calcification over the previous lesion, our patient had a very favourable outcome.&lt;/p&gt;

Preliminary results of surgical treatment of fibrous dysplasia of proximal femur in children

Objective: To investigate the surgical treatment, clinical effect and revision reasons of children with proximal femoral fibrous dysplasia(FD). Methods: The clinical data of 26 children with polyostotic FD of proximal femur who underwent surgery at Department of Pediatric Orthopaedics, Beijing Jishuitan Hospital from June 2016 to June 2018 were retrospectively analyzed. There were 18 males and 8 females with a mean age of 9.2 years (range:5 to 16 years).One of them was McCune Albright syndrome. Fifteen cases were in first operation and 11 cases were in revision operation. The operation methods and results were reviewed,and the causes of revision were analyzed. Results: Among the 15 children who underwent the first operation,13 cases underwent osteotomy or fracture reduction and interlocking intramedullary nail(IMN) fixation;One case underwent valgus osteotomy and pediatric hip plate(PHP)internal fixation;One case underwent valgus osteotomy+lesion curettage+allogeneic bone graft+PHP fixation. Among the 11 children who underwent revision surgery,9 cases were treated with IMN fixation,1 case with PHP fixation,and 1 case with PHP fixation+allogeneic bone graft. The causes of revision included distal fixation failed in 6 cases,proximal fixation failed in 3 cases,plate fixation failed in 5 cases,and recurrence occurred after curettage and artificial bone graft in 2 cases. Patients were followed up for 1.4 years(range:1.0 to 3.5 years) after recent operation. The osteotomy or fracture healed well with good deformity correction. Postoperative complications included infection in 1 case and local bone partial resorption in 1 case. Conclusions: Osteotomy combined with rigid internal fixation is an effective surgical treatment for fibrous dysplasia of proximal femur in children. Internal fixation should cover the whole length of lesion. Intramedullary nail is the most common choice. Because the growth of height and the progress of the disease itself,this deformity is prone to recur in children,needing closely follow-up after operation.

Management of Fibrous Dysplasia of Proximal Femur by Internal Fixation Without Grafting: A Retrospective Study of 19 Patients.

Introduction:This paper assesses whether treating patients with fibrous dysplasia of proximal femur by internal fixation with correction of the deformity, if present, without grafting is enough or not.Methods:This study is a retrospective study using patient's medical records, including analysis of 19 patients with fibrous dysplasia of proximal femur treated by internal fixation only and followed up between 2000 and 2017 for at least 2 years. Epidemiologic data, clinical manifestations, radiologic and histologic investigations, surgery, functional outcomes, and complications in these patients were analyzed.Results:The study included 12 male patients and 7 female patients, with a mean age of 20.74 years. Of these, two patients presented with pathologic fractures, two presented with shepherd's crook deformity, and the remaining presented with hip pain and limping. Implants used for internal fixation were intramedullary nail in four patients, dynamic hip screw in eight patients, cannulated screws in four patients, broad dynamic compression plate in two patients, and narrow dynamic compression plate in one patient. The mean follow-up period was 53.58 months. Four patients had postoperative complications. The mean Musculoskeletal Tumor Society score was 27.63 points.Discussion:The optimal management option for fibrous dysplasia of proximal femur is debatable. We suggest that internal fixation without grafting has a good local control and satisfactory functional long-term outcome.

A case of monostotic fibrous dysplasia of proximal femur managed with curettage and cortical bone grafting

We present a case report of a young military personnel with monostotic fibrous dysplasia of proximal femur with painful, dysplasticlesion of the femoral neck and fatigue fracture who underwent cortical bone grafting using autogenous fibular strut graft and iliac crest bone graft. The fibular cortical grafts was used to bridge the lesion in the femoral neck and were securely anchored to the normal bone of the lateral femoral cortex and a head of the femur. No supplemental internal fixation was required.