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Fibula grafting for treatment of aggressive benign bone tumor and malignant bone tumor of extremities.

OBJECTIVE: To compare the effect of vascularized and nonvascularized fibula grafting performed for the reconstruction of bone defects after the resection of bone tumors. METHODS: Vascularized fibula grafting was performed in 18 patients with malignant or aggressive benign bone tumor of the extremities. Non-vascularized fibula grafting was performed in 15 patients with giant cell tumor of the radius. All the 18 patients were followed up with radiography, single photon emission computed tomography (SPECT), colored Doppler's sonography (CDS) examinations and functional observation for 2 to 14 years. RESULTS: Vascularized fibula grafts with bone defects of 9 to 26 cm showed good blood supply in emission computerized tomography (ECT) and radiography examinations, and bone union was achieved (Table 1). In non-vascularized fibula grafting cases (Table 2), bone union was not achieved. CONCLUSIONS: The advantages of vascularized grafting are the feasibility of one-stage reconstruction of various tissues and the growth of grafted fibula. It is necessary to adopt vascularized fibula grafting to reconstruct large bone defect resulting from the resection of extensive bone tumors, such as giant cell tumor (GCT), fibrous dysplasia of bone and malignant bone tumors.

Adolescent↗

An unusual case of craniofacial fibrous dysplasia presenting in early infancy.

Fibrous dysplasia (FD) of bone is one of the most frequently encountered anomalies of skeletal development. It may involve one or more bones and, particularly when polyostotic, is sometimes associated with abnormal skin pigmentation and endocrine abnormalities. FD occurs mainly in large limb bones, ribs, and craniofacial bones in older children and young adults. Usually craniofacial involvement is detected because of local swelling or asymmetry of the face or head. Neurological symptoms, primarily due to involvement of the foramina, have been reported but are not common. Infantile fibrous dysplasia of the craniofacial region has rarely been reported.

Angiography↗

Fibrous dysplasia of the mandible and sphenoid bones: report of case.

A case of fibrous dysplasia of the mandible has been presented in which further diagnostic procedures showed the presence of a second and potentially more dangerous lesion. The literature was reviewed with the purpose of bringing attention to the still confused state of fibro-osseous lesions of the jaws and skeleton. The relationship of the ossifying fibroma and fibrous dysplasia was explored in relative depth. Fibrous dysplasia is a usually benign fibro-osseous abnormality of bone that may occur as monostotic, polyostotic, or craniofacial disease or as a part of a syndrome. Its nosology is confusing and its etiology is still unknown.

Adolescent↗

Hypophosphataemic osteomalacia in fibrous dysplasia.

We describe three patients with fibrous dysplasia of bone in whom there was evidence of hypophosphataemic osteomalacia or rickets. Two of the patients had polyostotic fibrous dysplasia and osteomalacia. The third was a child with fibrous dysplasia of the facial and cranial bones and rickets. In all cases the manifestations of osteomalacia or rickets were controlled with large doses of vitamin D. In the child the rickets and hypophosphataemia ceased when most of the bone affected by fibrous dysplasia was surgically resected. Previously reported cases of the association between fibrous dysplasia and hypophosphataemic osteomalacia are reviewed. We suggest that these cases are analogous to the syndrome of 'tumour rickets' where hypophosphataemia appears to be due to the presence of a mesenchymal tumour and regresses when the tumour is removed.

Adult↗