Management of monostotic fibrous dysplasia of proximal femur – A case report

Fibrous dysplasia is a developmental disorder of bone that can present in a monostotic or polyostotic form. Primarily affecting adolescents and young adults, it accounts for 7% of benign bone tumors. Many of the asymptomatic lesions are found incidentally; the remainder present with symptoms of swelling, deformity, or pain. Fibrous dysplasia has been associated with multiple endocrine and nonendocrinedisorders and with McCune-Albright and Mazabraud’s syndromes. The etiology remains unclear, but molecular biology suggests a mutation in the Gsα subunit andactivation of c-fos and other proto-oncogenes. Fibrous dysplasia has characteristicradiographic appearance. Most cases do not require intervention, but those that dousually are managed surgically with curettage, bone grafting, and, in some cases, internal fixation. When some intervention is necessary but surgery is not practical, treatment is with bisphosphonates. The prognosis generally is good, although pooroutcomes are more frequent in younger patients and in those with polyostotic formsof the disease. The risk of malignant transformation is low. We report a case of unilateral monostotic fibrous dysplasia in a 19 year old female in a proximal femur with pathological neck fracture with Shepherd' crook deformity. The patient underwent a curettage of lesions combined with dynamic hip screw fixation and bone grafting. The patient was followed up in the outpatient department(opd),x rays was taken, signs of radiological healing was noted Partial weight-bearing was allowed at three months postoperatively and full weight-bearing at six months with no restriction in the activity. After six months, the patient was able to perform all activities without any difficulty. No evidence of recurrence was noted in the follow-up x-rays. After five years of follow up, implant exit done along with fibular strut graft done