الفهرس 
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Abstract
FD is a benign intramedullary fibro-osseous lesion and represents almost 5% to7% of the whole benign bone tumors. Presenting in only one bone (monostotic) or presenting in multiple bones (polyostotic). Clinical presentation may happen at any age as incidental, pain, limping, or deformity. The pathophysiology of the disease is the failure of maturation of the lamellar bone. Its etiology is due to mutation activation in the gene that contains the α subunit of stimulatory G protein (Gsα).
Lesions in the proximal femoral area are biomechanically subjected to high local stresses that often lead to fracture, varus deformity, and shepherd’s crook deformity.
The symptoms are resulting from repeated fissures caused by the lesion.
The treatment modalities are to cure recent presenting fractures, correct deformity, or prophylactic preventing future morbidities (fractures or deformity).
This study aimed to evaluate the functional outcome of the treatment of proximal femoral FD by internal fixation with the use of graft and without the use of graft.
This study was an observational study that had been conducted in the period from 2013 to 2019 at Menoufia university hospital, using an individual analysis of the clinical notes for 15 patients diagnosed with proximal femoral FD who underwent internal fixation.
History of skeletal sarcomas and pregnancy are exclusion criteria.
In this study, different types of internal fixation were used. Among the 15 patients, DHS was the majority with 40 % followed by IMN 20%. Other modalities included proximal femoral plate and K- wires by 13.3%, small DCP by 6.7%, and DCS by 6.7%.
Two patients had valgus osteotomy with internal fixation.
No patient received bisphosphonates or radiotherapy before surgery.
None of the patients had endocrine abnormalities.
Assessment of functional outcomes using MSTS score at 3 and 6 months post-operative.
Assessment of epidemiologic data, clinical manifestations, radiologic investigations, method of fixation, and complications.
Regarding the MSTS score, the MSTS score at 3 months was 24.73 and 27.26 at 6 months postoperatively these results were considered satisfactory.
Regarding postoperative complications: Only 20 % of patients had postoperative complications. One patient had a superficial infection who responded to antibiotics and became free. One patient has leg length discrepancy (LLD) 1 cm increased on the same side who went for a shoe lift the same length in the contralateral side. One patient had residual mild pain and relieved.
Using bone grafting in three patients: No major difference between cases used graft and cases didn’t. More ever using graft has a morbidity effect on the donor site and operation time-consuming.
Internal fixation of the proximal femoral FD could be more than enough as a definite treatment without using bone grafting, lessen the time of operation, morbidity of skin donor and post-operative rehabilitation occur without the use of additional grafting.