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Year : 2022  |  Volume : 19  |  Issue : 1  |  Page : 7-16

Fibrous dysplasia; Is aggressive treatment justifiable?

Department of Orthopaedics, Amala Institute of Medical Sciences, Thrissur, Kerala, India

Correspondence Address:
K Ajith John
Quarters Number 12, Inside Amala Hospital Campus, Amala Institute of Medical Sciences, Amala Nagar, Thrissur - 680 555, Kerala
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/joasis.joasis_24_21

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Purpose: Fibrous dysplasia (FD) is a bone lesion resulting from the displacement of the normal medullary bone, with abnormal fibro-osseous tissue. The aim of the study is to investigate the clinicopathological profile of FD, and the objective is to lay out treatment protocol for this condition. Materials and Methods: 25 patients with 29 lesions including 9 femora (31%), 5 tibia (17%), and 4 humerus (14%), 3 rib, 3 ulna, 3 radius, 3 fibula, and 1 pelvis included for the study. Results: The two children who presented with lesions in the trochanter and later had pathological fracture who subsequently treated by fixation with implants were fine during final follow-up, rest of cases in upper femur graft served the purpose and remained asymptomatic in the final follow-up. Humerus and tibia case treated with fibular grafting during childhood didn't served the purpose as the grafted fibula was replaced by dysplastic bone. In contrast to that fibula is used as a graft gives good result in patients nearing skeletal maturity and also in adult. Lesions that are left alone remained as such except for the increased size during adolescent growth spurt. Conclusion: conservative management (observation alone) is enough in most cases of FD. Peri trochanteric region need surgery and were highly dependent on the patient's age at time of the initial presentation. In patients who were skeletally mature, the result was satisfactory with either fibular graft. In contrast, patients who were skeletally immature, fibular graft gets involved in the disease process and do not serve its purpose.

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