Jarrad Stevens1,2, Sarah Moin3, Donald Salter4, James T Patton1. 1. Department of Surgery, Orthopaedics, Royal Infirmary Edinburgh, Edinburgh, Scotland. 2. Knox Orthopaedic Group, Knox Private Hospital Melbourne, Melbourne, Australia. 3. School of Medicine, The University of Edinburgh, Edinburgh, Scotland. 4. Department of Pathology, Royal Infirmary Edinburgh, Edinburgh, Scotland.
Abstract
CASE: We report a rare case of desmoplastic fibroma (DF) of the midshaft femur presenting as a pathological fracture. This rare benign bone tumor was treated with an acute en bloc excision and femoral shortening over an intramedullary nail. Once union of the acute shortening had been achieved, further surgery was undertaken to lengthen the femur with the use of Intramedullary Skeletal Kinetic Distractors. At 3 years after fracture, our patient had achieved equal leg lengths, had normal knee function, and was disease free. CONCLUSIONS: DF resulting in pathological fracture of the midshaft femur is extremely rare and has not been reported to occur in the femoral diaphysis. This location is important as preservation of the joint above and below is preferable and en bloc excision is recommended. Restoration of bone stock after en bloc excision is difficult and recurrence needs to be monitored.
CASE: We report a rare case of desmoplastic fibroma (DF) of the midshaft femur presenting as a pathological fracture. This rare benign bone tumor was treated with an acute en bloc excision and femoral shortening over an intramedullary nail. Once union of the acute shortening had been achieved, further surgery was undertaken to lengthen the femur with the use of Intramedullary Skeletal Kinetic Distractors. At 3 years after fracture, our patient had achieved equal leg lengths, had normal knee function, and was disease free. CONCLUSIONS: DF resulting in pathological fracture of the midshaft femur is extremely rare and has not been reported to occur in the femoral diaphysis. This location is important as preservation of the joint above and below is preferable and en bloc excision is recommended. Restoration of bone stock after en bloc excision is difficult and recurrence needs to be monitored.
Authors: Marcos Roberto González; Mayte Bryce-Alberti; Ty Subhawong; Muhammad Hakim; Andrew Rosenberg; Juan Pretell-Mazzini Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2021-06-02