Outcomes of Surgical Interventions in Children With Fibrous Dysplasia/McCune-Albright Syndrome.

Authors

Oana Ofelia Bulaicon, Jenna van der Kruk, Sjoerd Joustra, Michiel van de Sande, Natasha Mireille Appelman-Dijkstra, Pieter Bas de Witte

Published in

Journal of pediatric orthopedics. Oct 02, 2026. Epub Oct 02, 2026.

Abstract

Fibrous dysplasia/McCune-Albright (FD/MAS) is a rare bone disorder with an increased risk of skeletal deformities and fractures. Data on surgical indications, techniques, outcomes, and complications remain limited.
An observational retrospective cohort study was conducted on children with FD/MAS who underwent FD-related orthopaedic surgery before the age of 18 years. Time-to-event analyses were performed, with the event defined as (re)fracture or second surgery after the first surgery.
A total of 45 children with FD/MAS were included (57.8% boys), with a median age of 10 years at diagnosis and 13 years at first surgery. In total, 64 surgical sites were included, and the median follow-up was 10 years (range 0.8 to 25.3). Surgery was performed for (impending) fractures in most cases (n=45, 70.3%), involving the proximal femur in 50.0%. Most frequently performed were osteosynthesis with hardware/implants (56.3%), followed by cortical strut grafting (21.9%). (Re)Fractures were the most common complication, often adjacent to the surgical site of the previous surgery. The probability of remaining free from an event was 70.3% at 1 year and 41.9% at 5 years. Increased risk of an event was associated with female sex (HR 2.2, 95% CI: 1.1-4.5, P=0.02) and lower age at index surgery (HR 0.93 per year increase, 95% CI: 0.86-0.99, P=0.04).
In this largest series of children with orthopaedic surgery for FD/MAS, the proximal femur was the most common surgical site, typically for (impending) fractures. Risk of an event ((re)fracture or second surgery) was higher in females and those operated at a younger age.
Level III.

PMID:
42826036
Bibliographic data and abstract were imported from PubMed on 03 Oct 2026.

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