Fibrous dysplasia of bone
ICD-10 M85.0 · ICD-11 FB80.0.1

Treatment of Long Bone Fracture, Impending Fracture, Stress Fracture, or Limb Deformity in Fibrous Dysplasia of Bone

Fibrous dysplasia can structurally compromise long bones, resulting in mechanical pain, stress fractures, impending fractures, or progressive limb deformity. Each of these presentations requires specialist orthopaedic assessment and a tailored surgical plan.

Clinical Scenario

This protocol applies to patients with fibrous dysplasia who present with a long bone fracture, an impending fracture, a stress fracture, or limb deformity. Mechanical or weight-bearing bone pain can signal a stress or impending fracture and should prompt urgent evaluation. Limb deformity warrants early assessment for prophylactic intervention to prevent worsening deformity, pain, and fracture. Review by a specialist orthopaedic surgeon is indicated for fracture, potential mechanical or tumour bone pain, or limb deformity.

Surgical Approach — Overview

Management in this setting involves internal fixation using titanium implants selected and positioned to bridge the affected bone segment. The stabilisation procedure may be combined with additional steps to correct alignment where needed. Full implant selection criteria, indications, and the complete surgical algorithm are detailed in the protocol.

Complete regimen — including implant type selection, technique, and adjunct procedures — available via the link below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1186/s13023-019-1102-9

  • Mechanical/ weight bearing bone pain can signal a stress or impending fracture.
  • Limb deformity requires early assessment for prophylactic surgery to prevent worsening deformity, pain and fracture.
  • Review by a specialist orthopaedic surgeon is needed for fracture, potential mechanical/ tumour bone pain or limb deformity.
  • This should trigger consideration for correction of alignment, and/or consideration for the necessity of a surgical procedure, possibly involving the use of an intramedullary titanium nail or custom-made titanium angled blade plate, based on the 'bridging the defect' principles, to stabilize the involved bone.
  • Preferred internal fixation is with a titanium intramedullary nail, bridging the involved bone where possible.
  • Internal fixation using conventional titanium plates or custom-made titanium plates by bridging the involved bone is another option.
  • The stabilization procedure is often facilitated by performing a correction osteotomy.
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