Treatment strategies for fibrous dysplasia

In fibrous dysplasia (FD), growth of the lesions usually arrests around early adolescence. However, in some cases, it continues even after this period, and it is not clear under what kind of conditions this growth continues. If this continued growth could be predicted, it would provide a vital assessment tool to determine when bone contouring should be performed. We were able to find numerous reports about FD concerning surgical procedures, but only a small number included long-term postoperative follow-up. In this paper, we investigated 11 patients with FD who were available for a postoperative follow-up longer than a 10-year period. Of these 11 patients, 6 were male and 5 were female, and the mean initial assessment age was 17.9 years. Three cases were diagnosed as Albright syndrome, 3 as monostotic, and 5 as polyostotic. Regrowth after the operation occurred in 9 of the 11 patients. Among these, growth was arrested in 5 patients at the average age of 23 years, and growth is still being observed in the remaining 4 patients including 3 patients with Albright syndrome. No statistically significant difference was detected between the affected bones and the age of growth arrest, mean age of growth arrest, and sex. Consequently, we believe it is best to perform bone contouring subsequent to growth arrest other than Albright syndrome. When growth continues indefinitely in patients with the polyostotic type, as with Albright syndrome, recurrence of the disease and the resultant deformities are predicted, so complete resection and reconstructive surgery is recommended.