Focal fibrocartilaginous dysplasia in the ulna with the radial head dislocation: a case report and literature review

Abstract

Focal fibrocartilaginous dysplasia (FFCD) is a rare benign bone lesion, which mainly occurs in the proximal tibia. In the upper extremity, only 21 cases have been reported so far and 14 of these involved the ulna. We present an additional case of FFCD in the distal ulna that showed progressive bowing of the right forearm and the radial head dislocation. Resection of the abnormal tissue, osteotomy of the radius and ulna, and gradual lengthening of the ulna were performed. On the basis of the previously published data of 14 cases and our data, we have summarized the etiology, clinical features, natural history, and treatment of FFCD in the ulna.

Diagnosis and treatment of focal fibrocartilaginous dysplasia of the distal ulna

“…In our study, 12 months after the first operation, the ulna of all patients remodeled well, and there were no new occurrences of radial head dislocation. Resection of the lesion is minimally invasive and requires no specific fixation postoperatively, and no postoperative complications have been reported in our case or other works of literature [6][7][8][9]. We, therefore, believe that resection of the lesion should be performed as soon as the lesion is determined to be still present by MRI.…”

“…According to the literature, tibial deformity can be corrected gradually with a good prognosis. Most authors believe that the cause of self-healing is the rupture of band-like structures [4][5][6][7][8][9][10].…”

“…However, few reports clearly provide the corresponding medical history. The typical fibroligamentous tether stretches the epiphysis of the distal ulna resulting in the shortening and angular deformity of the ulna, followed by dislocation of the radial head [6][7][8][9][10].…”

“…However, compared with FFCD in the lower limb, the spontaneous resolution of FFCD in the distal ulna seems to be less likely in a young child. The radial head subluxation or dislocation can develop before the operation [6][7][8].…”

“…FFCD in the upper limb is less common. The distal ulna is a common site for FFCD in the upper limb, which is only reported in a few case reports [6][7][8][9][10].…”