Osteofibrous dysplasia of the tibia and fibula is not a well recognized
entity. We have seen thirty-five patients with the disease. Twenty-two
comparable cases have been reported in the literature with such diagnoses
as ossifying fibroma, congenital fibrous dysplasia, and congenital fibrous
defect of the tibia. The main differential diagnosis is with fibrous
dysplasia and with adamantinoma of a long bone. Twelve of our patients had
long-term follow-up and some of the lesions regressed spontaneously.
Osteofibrous dysplasia seldom has even a moderate tendency to progress
during childhood, but it recurs frequently after curettage or subperiosteal
resection. Such recurrences generally are moderately progressive or not
progressive at all. Any progression of the lesion comes to an end after
puberty. Attempts at radical surgery either primarily or after recurrence
do not seem to be necessary. Surgery should be delayed as long as possible
and should be restricted to extensive lesions. The results of surgical
treatment usually are good even in patients with a recurrence, fracture, or
pseudarthrosis.