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KMID : 0613319980040030149
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Journal of the Korean Bone and Joint Tumor Soceity
1998 Volume.4 No. 3 p.149 ~ p.155
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Treatment of Fibrous Dysplasia Involving the Proximal Part of the Femur
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Park Il-Hyung
Park Chan-Sig
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Abstract
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The proximal part of the femur is one of the most common site of fibrous dysplasia and involvement of this area is progressive and disabling that leads to deformity and recurrent fracture. Authors reviewed our 25 cases of fibrous dysplasia involving the proximal femur. Among the 25 patients, 18 cases were polyostotic fibrous dysplasia and 7 cases were monoostotic type. 13 were male patients. The average age was 27 years old. Mean follow up was 3.2 years(from thirteen to eighty one months). Twenty four cases were unilateral and one was bilateral involvement in a patient with Albright´s syndrome. The extent of involvement is total femur in fourteen cases, carvico-trochanteric in eight, more than two sites involving proximal femur in six and ipsilateral pelvic side in five. Diagnostic modality were simple radiography and Tc 99m bone scan in all 25 cases, and additional CT in 12, MRI in 11 cases. 22 cases were confirmed by histologic biopsy and 3 cases were not biopsied and follow up with closed observation only. The final outcome by Stephenson´s classification were better in patients who were treated with freeze-dried cancellous allograft than in patients treated with autogenous bone graft. In summary, the insufficient curettage seemed to be main cause of recurrence of the lesion. We believe that sufficient amount of cancellous allograft would be superior to insufficient autogenous cancellous graft and stable internal fixation should be performed to prevent progression and recurrent fracture.
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KEYWORD
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Proximal femur, Fibrous dysplasia, Allograft
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