Possible Novel Treatment Modality for Non Ossifying Fibroma Neck of Femur

Abstract

Nonossifying fibromas (NOFs) are benign bone tumors occurring in the second decade of life. Most of the NOFs are diagnosed incidentally on the basis of its presentation on plain radiographs where they typically appear as small, cortical osteolytic lesions with sclerotic margin. They are mostly asymptomatic but can result in pathologic fractures if the lesion involves more than 50% of bone diameter. They are mostly treated with curettage and bone grafting. But in challenging situations where the classical surgery has failed or there is impending fracture of the neck of femur, bone structural support is needed. We are discussing two cases diagnosed as NOFs of intracapsular femoral neck. Both cases underwent curettage of tumor followed by free vascularized fibular graft. Results in both the cases were very gratifying, with complete resolution of symptoms during 1 year of follow-up.

The Role of Surveillance in Predicting Fracture in Pediatric Patients With Incidentally Discovered Nonossifying Fibromas and Fibrous Cortical Defects: Is It Worth It?

“…Furthermore, surgical consideration may be necessary with high-risk lesions in locations such as the femoral neck, where pathologic fracture can lead to avascular necrosis. But the 5 patients in our study with femoral neck lesions did not develop pain or lesion progression, so we are unable to extrapolate appropriate recommendations from 1.3% of total lesions in the study and other high-risk areas 11 …”

“…But the 5 patients in our study with femoral neck lesions did not develop pain or lesion progression, so we are unable to extrapolate appropriate recommendations from 1.3% of total lesions in the study and other high-risk areas. 11 Considerable resources were devoted to follow-up, which eventually led to the observation of only 2 pathologic fractures, 17 times less than the number of pathologic fractures that were discovered incidentally. This, along with our analysis of previously established lesion characteristics, supports our hypotheses that most NOF/ FCDs fracture without prior documentation of the lesion, and there are likely no clinical or radiographic features that can accurately predict pathologic fractures when patients with NOF/FCD present with incidental findings.…”

A nonossifying fibroma of the femoral neck treated with curettage and dynamic hip screw with free fibular bone graft: a case report

“…The treatment of choice in such cases in young patients is curettage with vascularized fibula graft with or without fixation 12 , applying such treatment required a surgeon with experience in microscopic surgery and well-equipped center, the fixation can be done by cannulated screws or DHS, in the older patients, Total Hip Replacement could be considered.…”

Non-ossifying Fibroma Pathological Fracture in a Patient With Lactose Intolerance

“…In this critical case, vascularized fibular graft provided mechanical cortical support along with regenerative potential. Hence, vascularized fibular graft might be a new possible treatment for a more challenging union [ 16 ].…”