Clinical outcomes of treatment of benign cystic lesions of proximal femur with non-vascularized autologous fibular strut graft and supplementary fixation with cannulated cancellous screw

Abstract

The aim of the study was to evaluate results of benign cystic lesions of proximal femur treated by non vascularized autologous fibular strut graft and supplementary fixation using cannulated cancellous screw. Non vascularized autologous fibular strut graft which act as mechanical as well as biological graft. The hypothesis behind this study to add fixation to fibular strut graft which helps in immediate structural support, early consolidation of defect and remodeling. Methods and Materials: We prospectively and retrospectively evaluated clinical outcomes of surgically treated 8 patients with benign lytic lesions of proximal femur. Out of these 6 were males and 2 females with mean age of presentation was 17 years. Average follow up time was 36 months. Histological diagnosis included simple bone cyst, aneurysmal bone cyst, fibrous dysplasia. Results: 8 patients with benign cystic lesions of proximal femur were treated with curettage and autologous fibular strut grafting. The average operation time was 148 minutes. All patients were allowed unprotected full weight bearing by a mean of 13.2 weeks after surgery. All patients had regained normal unrestricted activity without pain by 12 months of follow up. None of the patients sustained pathological fracture of femur following the surgery. All patients achieved partial or complete consolidation of the lesion within 8 months. None of the patients had local recurrence of tumor in their long follow up. None of the patients were suffered from postoperative wound infection, deep vein thrombosis, chronic hip pain. Conclusion: We conclude that non vascularized autologous fibular strut graft with internal fixation using cannulated cancellous screws is a safe and effective method of treatment for benign cystic lesions of proximal femur.