Monday, May 30, 2011

Fibrous dysplasia of bone - Treatment

Understanding the disease has progressed enormously in recentyears. The mutation was identified, but the pathogenesis leading toabnormal differentiation of osteoclasts and their function is justbeginning research. In future it may be possible nonchirurgicaleeffective treatments. The risk of local recurrence is high, so the decision to treat must be made ​​knowing the consequences. In general purpose is to ameloiora surgery pain and stabilize the bone, than to excise the affected bone. The condition isdiscovered accidentally, and the need for prophylactic treatment isdifficult to accept for a patient nonsimptomatic.

Although no specific medical therapy for fibrous dysplasia, studiesshow pain reduction after treatment with bisphosphonates.Bisphosphonates inhibit bone resorption through their action onosteoclasts. Most used therapy is intravenous pamidronate. Heproposed an infusion of 1 mg / kg / day of pamidronate every 3days for 3-6 months. Vitamin D and calcium therapy should beadded. This therapy in children appears to be safe, but studies are still needed to confirm the absence of collateral effects on growthplateaus. Their thickening was found in children treated with thisprocedure.

After treatment, patients need surveillance to prevent deformitiesas a result of the disease. Bone radiographs are recommendeduntil reaching skeletal maturity. Fibrous dysplasia rarely sufferremission. For this reason, regular monitoring of disease progression indicated, especially in skeletally immature patients.Once they have reached skeletal maturity, it is unusual for fibrousdysplasia lesions of monostotic evolve. Early intervention with internal fixation of bone affected is important in preventingdeformity.

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