BACKGROUND/AIMS

Fibrous dysplasia (FD) is a skeletal system disorder characterized by replacement of normal bone and bone marrow with fibro-osseous tissue and proliferation of immature osteogenic cells. There is no consensus regarding the timing of orthopedic surgery, the choice of implants, and use of grafts owing to its variable clinical appearance and wider age range. This study aimed to contribute to the literature by performing a retrospective study involving patients with FD.

MATERIAL and METHODS

This retrospective study included 41 patients with FD. Patients were evaluated for the first-visit and follow-up graphs. Patients were examined for the effects of intramedullary nailing and plate fixation. The use of grafts during surgery was noted and examined in terms of increase in deformity during the operation time and follow-up.

RESULTS

Surgical intervention was performed on 45 bone lesions in 41 patients. Plate was used in 7 patients with pathological fracture, and intramedullary nail was used in 19 patients. There was a significant difference between the groups (P=.011). No deformity was detected in 16 of the 26 patients with pathological fractures. In 20 patients in whom grafts were used, cortical thickening was observed on the basis of the preoperative graphs. Graft survival rate was reported to be 83.3%.

CONCLUSION

The presence of pathological fractures affects the choice of implants by surgeons. Cortical thinning is the most important parameter than deformity in terms of the risk assessment of pathological fractures for surgical planning. Allograft survival rate is high for 4 years, on average.

Keywords: Fibrous Dysplasia of Bone , pathological fracture, allograft, monostotic fibrous dysplasia, polyostotic fibrous dysplasia