Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Nov 26, 2023; 11(33): 8050-8057
Published online Nov 26, 2023. doi: 10.12998/wjcc.v11.i33.8050
Fibula allograft transplantation combined with locking plate for treatment of recurrent monostotic fibular fibrous dysplasia: A case report
Lun-Li Xie, Xiao Yuan, Hong-Xia Zhu, Lei Fu, Dan Pu
Lun-Li Xie, Xiao Yuan, Lei Fu, Department of Joint and Hand Orthopedics, Hunan University of Medicine General Hospital, Huaihua 418000, Hunan Province, China
Hong-Xia Zhu, Department of Traumatic Orthopedics, Hunan University of Medicine General Hospital, Huaihua 418000, Hunan Province, China
Dan Pu, Department of Orthopedics, Hunan University of Medicine General Hospital, Huaihua 418000, Hunan Province, China
Author contributions: Xie LL designed, drafted, and revised the manuscript; Yuan X, Zhu HX, and Fu Lei acquired the data and played an important role in interpreting the results; all authors contributed equally to this work, and have read and approved the final manuscript.
Supported by The Scientific and Technological Innovation Platform of Huaihua, China, No. 2022F2701; and The Science and Technology Planning Project of Huaihua, China, No. 2021R3117.
Informed consent statement: Informed written consent was obtained from the patient for the publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lun-Li Xie, MD, Attending Doctor, Doctor, Department of Joint and Hand Orthopedics, Hunan University of Medicine General Hospital, No. 144 Jinxi South Road, Huaihua 418000, Hunan Province, China. xielunli@163.com
Received: August 25, 2023
Peer-review started: August 25, 2023
First decision: October 10, 2023
Revised: October 11, 2023
Accepted: November 14, 2023
Article in press: November 14, 2023
Published online: November 26, 2023
Processing time: 90 Days and 20.1 Hours
Abstract
BACKGROUND

Fibrous dysplasia is a congenital disorder in which normal bone is replaced by fibro-osseous tissue or irregular trabeculae of woven bone intermixed with mature collagenous tissue. A single or multiple bones are affected. This rare bone disorder has three clinical patterns including monostotic, polyostotic, and that associated with McCune–Albright syndrome. Most studies report primary fibrous dysplasia. However, a few cases of recurrent monostotic fibular fibrous dysplasia have been reported. Here, we report a therapeutic strategy for recurrent fibular fibrous dysplasia.

CASE SUMMARY

A 4-year-old boy was admitted for persistent pain in the left lower limb and abnormal gait over the previous 9 mo. He had no history of present or past illness. Preoperative imaging data showed erosion-like changes with bone expansion of the left middle and lower fibular segment. Tumor tissue in the fibular bone marrow cavity was removed by curettage, and rapid intraoperative pathological examination suggested fibular fibrous dysplasia. An allograft was implanted into the fibular medullary cavity. However, he was readmitted with clinical symptoms including persistent pain, abnormal gait, and local swelling at the age of 6 years. He was diagnosed with recurrent fibular fibrous dysplasia based on the second medical examination. He underwent fibular bone tumor radical resection and longus fibular allograft transplantation combined with fibular bone locking plate and screws. Good host bone to allogenic bone graft fusion was observed by the physician on postoperative regular follow-up.

CONCLUSION

Radical resection of fibrous dysplasia and longus fibula allograft combined with internal fixation for reconstruction are suitable for the treatment of recurrent monostotic fibular fibrous dysplasia.

Keywords: Recurrent fibrous dysplasia; Longus fibula allograft; Bone fusion; Case report

Core Tip: The incidence of recurrent monostotic fibular fibrous dysplasia is low. For recurrent fibrous dysplasia, radical resection combined with allograft bone for biodynamic reconstruction is a suitable therapy. We report a case of recurrent fibrous dysplasia in the left fibular bone treated by longus fibula allograft transplantation combined with fibula bone locking plate and screws.