Creator: Dr. Lokesh
Published: 2016-05-31T12:26:50-04:00

Patient's Query

Hi doctor,

I am suffering mild pain in the middle part of my right leg tibia. An MRI was done and the doctor said that I have fibrous cortical defect. I would like to know is it completely curable.

Answer

Dr. Lokesh

Orthopedics And Traumatology Spine Health Spine Surgery

Hi,

Welcome to icliniq.com.

Fibrous cortical defect is also called as non-ossifying fibroma. It is a benign tumor. It usually occurs in children and also usually in the tibia bone.

Most of the time it regresses on its own and casting is required. But, if the lesion is found to be too long or involving more than 40% to 50% of the bone or cortex, then surgery is required.

The surgical treatment is usually curettage with bone grafting. But, mostly it can be treated non-operatively.

It is fully curable either by non-operative or operative management.

If you follow up with x-rays, then I will be able to exactly give you an opinion in your case.

Revert back with the x-ray to an orthopaedician and traumatologist online --> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist

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Patient's Query

Thank you doctor,

I am sending snapshots of my x-ray and I hope it helps. Will I be able to play, run and do sport activities again? I am an active person and just a thought of not doing all these makes me tensed. Is there any side effect with the surgical or non-surgical therapy?

Answer

Dr. Lokesh

Orthopedics And Traumatology Spine Health Spine Surgery

Hi,

Welcome back to icliniq.com.

Your fibrous cortical defect is very small and is well surrounded by sclerotic bone (attachment removed to protect patient identity). So, you do not need to worry about it. It can heal very well with non-operative management.

But, for any benign or malignant tumor you need to do the following investigations. MRI scan of the tibia or fibula including knee and ankle joints and CT scan of the tibia or fibula with 3D reconstruction.

These investigations should be done for all tumors to know and be 100% sure of the type and extent of the tumor. Follow up with the reports.

As of the x-rays the tumor looks very benign, nicely encapsulated by sclerotic bone. It may be in the regression phase and incidentally detected.

From the x-ray it is evident that you do not require a surgery, but to be totally sure MRI and CT scan is needed.

Till then, you should wear a custom made leg brace made by an orthotist and walk always wearing the brace. This will reduce the stresses on the bone and prevent a fracture.

The brace should be worn till the time you do an MRI and CT scan.

Investigations to be done:

MRI and CT scan.

Regarding follow up:

Revert back with the investigation reports to an orthopaedician and traumatologist online.---> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist

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Patient's Query

Thank you doctor,

I got my MRI done. Here, two doctors saw it and recommended surgery, where they will scrape out the growth and send it for biopsy. It measures 7.4 x 6.9 mm. After this thing being scraped out and after recovery from surgery will I be able to run and jump like before? Do I need bone grafting for this?

Answer

Dr. Lokesh

Orthopedics And Traumatology Spine Health Spine Surgery

Hi,

Welcome back to icliniq.com.

After surgery the defect will heal in about two months and then you will be able to run and jump like before.

Bone grafts requirement is more of a decision taken at surgery. If more defect, then it will be required and vice versa. It is more a surgeon based decision.

Revert back with the reports to an orthopaedician and traumatologist online --> https://www.icliniq.com/ask-a-doctor-online/orthopaedician-and-traumatologist

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Patient's Query

Hi doctor,

I got my leg operated with the above problem. They scooped some of my bone for biopsy and in that report nothing was detected. It was not a tumor or infection. It was some tissue growth. And, the doctor did nit warned me properly after that surgery. Also, he did not know that I am a pretty active guy and told me to go back to daily life after two weeks. So, I did and while trying to get on a divider to cross street I broke my same bone from that region. Second surgery was done for that. They inserted a nail through my tibia. It is almost 1 year and 8 months after that surgery. The doctor saw my recent x-rays and said it has healed and the nail can be removed. I just want to take some more opinions before I say yes to surgery. Please check my x-rays and tell me If it is really healed properly and nail can be removed or not. Also, will I have any side effect or complication if I remove the nail? Because with the nail, I am perfectly fine while doing running, lifting weights, jumping and dancing like before. I am attaching three x-rays.

1. Broken leg x-ray. 2. X-ray taken after six months of surgery.3. Recent x-ray after healing i.e. about 2 weeks back from now.

Please check the file name for the above order.

Answer

Dr. Lokesh

Orthopedics And Traumatology Spine Health Spine Surgery

Hi,

Welcome back to icliniq.com.

I have seen your x-rays.

Your fracture has fully healed and it is safe to remove the nail now.

After removal of the nail, you can easily get back to your current active status which is running, jumping, etc.

Complications with removal of nail surgery include re-fracture which is rare, inability to remove the implant, breakage of implant, damage to nerve and vessels, re-operation, deep vein thrombosis, pulmonary embolism, anesthetic complications, and injury to patellar tendon. But these complications are not very common.

Probable diagnosis:

Query for implant removal.

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