The Journal of Bone and Joint Surgery, Vol 69, Issue 3 400-409, Copyright © 1987 by Journal of Bone and Joint Surgery, Inc
Fibrous dysplasia. An analysis of options for treatment
RB Stephenson, MD London, FM Hankin and H Kaufer
The results of treatment of sixty-five symptomatic lesions in forty-three
patients who had fibrous dysplasia were reviewed. For fourteen (93 per
cent) of the fifteen times that a lesion in the upper extremity was treated
non-operatively, the result was satisfactory. These results were
independent of the patient's age when first seen. In contrast, in the lower
extremity, the results were highly dependent on the age of the patients at
the time of the initial presentation of symptoms. In patients who were
eighteen years old or older, eight (88 per cent) of the nine times that a
lesion involving the lower extremity had closed treatment and both times
that a lesion was treated with curettage and bone-grafting, the result was
satisfactory. The results of these modalities of treatment in patients who
were less than eighteen years old were discouraging. Twenty-eight (88 per
cent) of the thirty-two times that closed treatment was used and
twenty-five (81 per cent) of the thirty-one times that curettage and
bone-grafting was used, the result was unsatisfactory. However, after
eighteen (86 per cent) of the twenty-one times that a lesion in the lower
extremity was treated by internal fixation in a patient who was less than
eighteen years old, there was a satisfactory outcome. We concluded that
closed treatment of a symptomatic lesion in the upper extremity generally
provides satisfactory results. In patients who are less than eighteen years
old, neither closed treatment nor curettage and bone-grafting is adequate
treatment for a symptomatic lesion in the lower extremity. Internal
fixation should be strongly considered in these young patients.
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