Intramedullary nailing for fibrous dysplasia of lower limbs

摘要

Fibrous dysplasia (FD) of the bone is rare and self-limiting. However, lesion expansion may occur, causing pain, deformity and pathological fracture, in which case surgery is occasionally required. Indicators of FD have not been previously described, although there are several surgical procedures reported (curettage, curettage and graft, and internal fixation). In this study we discuss whether intramedullary nailing of these lesions could result in more favorable outcomes in correcting deformities, including the prevention of secondary fractures and maintenance of the bone, compared to other internal fixation methods. A total of 39 patients with FD of the bone treated with intramedullary nailing were retrospectively analyzed. The surgical procedures involved curettage, grafting and intramedullary nailing. No infection, thromboembolism or other notable complications occurred. The patients resumed full activities of daily living. At the last follow-up, 33 patients presented no pain and seven patients had occasional mild pain. The clinical score according to the modified criteria of Guille improved from an average of 4.4 points prior to surgery to an average of 8 points following surgery. The neck shaft angle of the femur improved from an average of 90˚ prior to surgery to 125˚ following surgery. Intramedullary nailing may be used to correct deformity and prevent pain and refracture in FD of the bone of the lower limbs with large lesions, pathological fracture or deformities. All patients were allowed full athletic recovery following surgery.