Evaluation of subperiosteal hemicortical resection and bone grafting to treat tibial osteofibrous dysplasia in children.

ABSTRACT

Osteofibrous dysplasia (OFD) is a rare disease that may lead to tibial lesions. Currently, no gold standard method exists for the treatment of OFD. Recurrence is the most severe complication in OFD. Autogenous iliac bone grafting may reduce postoperative recurrence rates in children with tibial OFD. We aimed to evaluate the clinical effects of subperiosteal hemicortical resection in patients with OFD. We included 21 patients who were diagnosed with OFD. Retrospective clinical data were analyzed from our hospital between November 2009 and October 2016. All the tibial lesions were removed with a subperiosteal hemicortical resection, and bone grafts were implanted. Patient age, sex, symptoms, lesion site, imaging, surgical methods, and histopathological data were analyzed. Local recurrence, postoperative recovery, and postoperative function were evaluated. The postoperative function was evaluated using the Musculoskeletal Tumor Society score (MSTS). OFD recurrence postsurgery occurred in eight patients; seven had no further recurrence after a second procedure, while one patient did not undergo another procedure. There were statistical differences in postoperative recurrence rates between the autogenous and other graft groups (P = 0.046). The median MSTS was 28 (27-30) and 30 (29.5-30) in the nonautologous (n = 15) and autologous graft groups (n = 6), respectively. The function of the nonautologous graft group was significantly worse than that of the autologous group (P = 0.029). We recommend that patients with tibial OFD undergo subperiosteal hemicortical resection plus autogenous iliac bone grafting. Our study findings showed that these patients experience reduced postoperative recurrence rates and improved prognostic function. Level of Evidence IV.