Curettage and Bone Grafting for Monostotic fibrous dysplasia - A case report

Abstract

Abstract : INTRODUCTION Fibrous dysplasia is a common benign tumour comprising of 5-7 percent of benign bone  tumours - most commonly affecting long bones. Bone pain is the commonest mode of presentation of monoostotic fibrous dysplasia. Herewith presenting a case of mono-ostotic fibrous dysplasia treated with curettage and bone graft with a               combination of autograft and allograft.MATERIALS AND METHODS A 17 year old male presented with left hip pain of 1 year duration which restricted activities of daily living.             Examination revealed normal range of movements. X rays revealed the presence of bony cyst - fibrous dysplasia.            Skeletal survey ruled out other bone involvement. Mirels  criteria had a score of 10 suggesting the need for prophylactic fixation to prevent pathological fracture. Through lateral            approach the cyst was approached. A cortical window was created and cystic contents removed and sent for biopsy. Complete curettage of the lesion done. The cavity was packed with autograft harvested from ipsilateral iliac crest and allograft from 2 femoral heads.RESULTS The biopsy report confirmed the diagnosis of fibrous dysplasia. The patient had uneventful post operative period. Upon 1 year follow up the patient has returned to previous activity levels and                 improvement in pain according to visual analogue scale. Pathological fracture has also been prevented and the lesion has not progressed in size.CONCLUSION Curettage and bone grafting is a simple and effective procedure for the        treatment of mono-ostotic fibrous dysplasia. The amount of graft needed to fill the cavity after curettage may be large and may need allograft in addition to autogenous cancellous bone

Keyword :Monostotic fibrous dysplasia, impending                   pathological fracture, auto-allograft