Treatment of Benign Lesions of the Femoral Head and Neck

Benign lesions of the proximal femur usually weaken the supporting framework in the femoral neck. Of seven patients aged 11 through 26 years with the diagnosis of fibrous dysplasia (four), aneurysmal bone cyst (two), and simple bone cyst (one), six were treated with curretage and an autogenous fibula strut graft in conjunction with a sliding hip screw. One patient was treated with only the curretage and strut graft. The functional results were excellent (five), good (one), and fair (one), with no local recurrence. In treating fibrous dysplasia, dysplastic bone should be supplemented with grafts of cortical bone. This construct provides increased strength and prevents deformity and fracture, but it does not eradicate the disease. Internal fixation promotes union of the cortical graft to the host cancellous bone. The sliding screw stabilizes the bone and eliminates the need for plaster casts.