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Fibrous Dysplasia of Radius Bone-excision and Fibula Graft: A Case Report

INTRODUCTION: Fibrous dysplasia (FD) is a congenital disorder in which the bone is distorted and replaced by poorly organized and structurally unsound fibrous tissue. The disorder can be localized to a single bone or affects multiple bones. Although any bone can be affected, the bones of the upper e...

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Autores principales: Patankar, Hemant, Patankar, Soniya, Tandon, Nikhil, Bairy, Abhishek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826546/
https://www.ncbi.nlm.nih.gov/pubmed/36660157
http://dx.doi.org/10.13107/jocr.2022.v12.i05.2804
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author Patankar, Hemant
Patankar, Soniya
Tandon, Nikhil
Bairy, Abhishek
author_facet Patankar, Hemant
Patankar, Soniya
Tandon, Nikhil
Bairy, Abhishek
author_sort Patankar, Hemant
collection PubMed
description INTRODUCTION: Fibrous dysplasia (FD) is a congenital disorder in which the bone is distorted and replaced by poorly organized and structurally unsound fibrous tissue. The disorder can be localized to a single bone or affects multiple bones. Although any bone can be affected, the bones of the upper extremity are less commonly involved by the disease. The disease process results in deformity of the bones and is often complicated by pathological fractures. CASE REPORT: A 14-year-old girl presented with gradually progressive deformity of the right forearm for the past 1 year associated with mild pain. Skeletal radiographs of the right forearm revealed an expansile lytic lesion with ground glass appearance involving the proximal meta-diaphysis of the right radius, with its resultant bowing. The zone of transition was narrow and there was no evidence of matrix calcification. The lesion was causing thinning of the bony cortex. With this radiographic appearance in mind, a diagnosis of FD of the radius was put forth. The lesion was managed surgically. The proximal three-fourth of the radius bone was exposed and the lesion was excised along with 1 cm of normal bone on the distal side. Proximally, a thin shell of the cortex was preserved after curettage of the proximal end of the radius. Fibular cortical strut graft was harvested from the leg of same side. Graft length was kept 2 cm more than the excised bone to avoid shortening of the forearm. The graft was beveled on the distal end and jammed into the shaft of the distal radius such that 1 cm of graft was inside the original bone. A long arm or above elbow splint was applied keeping the elbow at 90 degrees of flexion and the forearm in supination for a total of 6 months. The patient was being followed up regularly. Follow-up radiographs obtained at 7 months revealed complete incorporation of the cortical bone graft with reformation of the intramedullary bone canal and restoration of hand and elbow function. CONCLUSION: Non-vascularized fibular cortical strut grafting is an effective treatment modality for FD of radius bone. External or internal fixation is not necessary if a tightly fitting cortical graft is jammed into the defect caused by lesion excision.
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spelling pubmed-98265462023-01-18 Fibrous Dysplasia of Radius Bone-excision and Fibula Graft: A Case Report Patankar, Hemant Patankar, Soniya Tandon, Nikhil Bairy, Abhishek J Orthop Case Rep Case Report INTRODUCTION: Fibrous dysplasia (FD) is a congenital disorder in which the bone is distorted and replaced by poorly organized and structurally unsound fibrous tissue. The disorder can be localized to a single bone or affects multiple bones. Although any bone can be affected, the bones of the upper extremity are less commonly involved by the disease. The disease process results in deformity of the bones and is often complicated by pathological fractures. CASE REPORT: A 14-year-old girl presented with gradually progressive deformity of the right forearm for the past 1 year associated with mild pain. Skeletal radiographs of the right forearm revealed an expansile lytic lesion with ground glass appearance involving the proximal meta-diaphysis of the right radius, with its resultant bowing. The zone of transition was narrow and there was no evidence of matrix calcification. The lesion was causing thinning of the bony cortex. With this radiographic appearance in mind, a diagnosis of FD of the radius was put forth. The lesion was managed surgically. The proximal three-fourth of the radius bone was exposed and the lesion was excised along with 1 cm of normal bone on the distal side. Proximally, a thin shell of the cortex was preserved after curettage of the proximal end of the radius. Fibular cortical strut graft was harvested from the leg of same side. Graft length was kept 2 cm more than the excised bone to avoid shortening of the forearm. The graft was beveled on the distal end and jammed into the shaft of the distal radius such that 1 cm of graft was inside the original bone. A long arm or above elbow splint was applied keeping the elbow at 90 degrees of flexion and the forearm in supination for a total of 6 months. The patient was being followed up regularly. Follow-up radiographs obtained at 7 months revealed complete incorporation of the cortical bone graft with reformation of the intramedullary bone canal and restoration of hand and elbow function. CONCLUSION: Non-vascularized fibular cortical strut grafting is an effective treatment modality for FD of radius bone. External or internal fixation is not necessary if a tightly fitting cortical graft is jammed into the defect caused by lesion excision. Indian Orthopaedic Research Group 2022 2022-05 /pmc/articles/PMC9826546/ /pubmed/36660157 http://dx.doi.org/10.13107/jocr.2022.v12.i05.2804 Text en Copyright: © Indian Orthopaedic Research Group https://creativecommons.org/licenses/by-nc-sa/3.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Patankar, Hemant
Patankar, Soniya
Tandon, Nikhil
Bairy, Abhishek
Fibrous Dysplasia of Radius Bone-excision and Fibula Graft: A Case Report
title Fibrous Dysplasia of Radius Bone-excision and Fibula Graft: A Case Report
title_full Fibrous Dysplasia of Radius Bone-excision and Fibula Graft: A Case Report
title_fullStr Fibrous Dysplasia of Radius Bone-excision and Fibula Graft: A Case Report
title_full_unstemmed Fibrous Dysplasia of Radius Bone-excision and Fibula Graft: A Case Report
title_short Fibrous Dysplasia of Radius Bone-excision and Fibula Graft: A Case Report
title_sort fibrous dysplasia of radius bone-excision and fibula graft: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9826546/
https://www.ncbi.nlm.nih.gov/pubmed/36660157
http://dx.doi.org/10.13107/jocr.2022.v12.i05.2804
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