Fibrous dysplasia of the proximal femur presents a unique surgical challenge. Progressive deformity, pathological fractures, and persistent pain often prompt intervention, yet the optimal treatment strategy remains controversial.
In our retrospective study of 19 patients, we explored whether internal fixation alone, combined with deformity correction when required, could provide durable outcomes without the addition of bone grafting.
Our experience demonstrated encouraging results:
🔹 Stable internal fixation provided effective local disease control over a mean follow-up of more than 4 years.
🔹 Patients achieved excellent functional recovery, with a mean Musculoskeletal Tumor Society (MSTS) score of 27.6/30.
🔹 Although postoperative complications occurred in a small number of patients, overall outcomes remained favorable and most patients returned to good function.
These findings suggest that bone grafting may not be routinely required when adequate mechanical stability is achieved. Instead, restoring alignment and selecting appropriate fixation may be the key determinants of long-term success.
While larger prospective studies are still needed, this work supports a more conservative reconstructive approach that may reduce surgical complexity without compromising patient outcomes.
📖 Reference
Ebeid WA, Hasan BZ, Mesregah MK. Management of Fibrous Dysplasia of Proximal Femur by Internal Fixation Without Grafting: A Retrospective Study of 19 Patients. JAAOS Global Research & Reviews. 2018;2(10):e057.
Walid Atef Ebeid, Bahaa Zakarya Hasan, Mohamed Kamal Mesregah
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