Functional outcome in surgical fixation of fibrous dysplasia of proximal femur
Keywords:Fibrous dysplasia, Benign bone tumour, Deformity of proximal femur, McCune-Albright syndrome
Background: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
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