Bilateral Tibia Fibrous Dysplasia in a Pediatric Patient Treated with Intramedullary Nailing: A Case Report

Fibrous dysplasia is benign developmental disorders of bone where normal lamellar cancellous bone is replaced with immature fibro-osseus tissue resulting in poorly formed trabeculae of immature woven bone. It may affect one (monostotic) or multiple bones (polyostotic). Polyostotic disease is less common, 20-25% of patients, mostly in children below 10 years old and tends to enlarge beyond bone maturation ration which can cause pain, progressive damage and higher tendency of pathological fractures.(1) We report a case of polyostotic fibrous dysplasia present on bilateral tibia diaphysis. Patient presented with bilateral leg pain on examination and imaging showed bilateral tibia lytic lesion. Management consisted of reaming and intramedullary nailing on bilateral tibia after which patient presented without pain and radiographs showing no evidence of lesion. Tibia x-rays demonstrated exuberant cortical intramedullary bone formation with disappearance of the scalloped osteolytic lesions on the inner wall of tibial cortex. Clinically the patient's symptoms disappeared giving the opportunity to return to contact sports without limitation.