Surgical treatment for fibrous dysplasia of femoral neck with mild but prolonged symptoms: a case series

Yoshihiro Nishida, Satoshi Tsukushi, Kozo Hosono, Hiroatsu Nakashima, Yoshihisa Yamada, Hiroshi Urakawa, Naoki Ishiguro

The proximal femur is one of the most common sites involved by fibrous dysplasia. In cases with mild deformity that does not require corrective surgery, occasional patients suffer sustained pain because of repeated microfractures. This study aimed to clarify the outcomes of surgery with autogenous fibular cortical strut grafting and compression hip screw fixation. Since 2002, eight consecutive patients (nine hips) with femoral neck fibrous dysplasia without severe deformity were prospectively treated with autogenous fibular strut grafting and compression hip screw fixation. Mean age of patients was 35 years. Mean follow-up of patients after surgery was 75 months. Most of the patients could walk with full weight-bearing 2 weeks after surgery. Functional score of lower extremity was significantly improved from 65 % to 95 % (P = 0.001). Femoral neck angle was increased from 127 to 130. Donor site of strut cortical fibula showed good regeneration with β-tricalcium phosphate. Autogenous fibular cortical strut grafting and compression hip screw fixation achieved good post-operative function and provided an early return to work for adult patients with fibrous dysplasia of the femoral neck with mild but prolonged symptoms. Morbidity in the donor site of fibula strut is minimal with the use of β-tricalcium phosphate.