Fibrous Dysplasia

Abstract

Fibrous dysplasia is a benign, intramedullary, fibro-osseous lesion with a predilection for the long bones, ribs, and craniofacial skeleton. The classic lesion is a long lesion in a long bone with a"ground-glass"textured medullary calcification and cortical thinning but no periosteal reaction. The weakened bone about a fibrous dysplasia lesion fails under repetitive mechanical loading, leading to acute and/or chronic pain. Pharmacologic management of fibrous dysplasia is directed toward inhibiting osteoclastic function. Surgical intervention is indicated when the patient has intense pain that has failed to respond to nonsurgical measures. All lesions treated surgically should undergo curettage and bone grafting with some form of stabilization. Lesions located at the end of a bone are typically secured with plate and screw constructs. Long bone lesions in the metadiaphyseal junction or diaphysis can be treated with curettage, bone grafting, and intramedullary fixation.

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