Treatment of Ossifying Fibroma

Ossifying fibroma is a benign tumor which arises typically within the jaw bone and rarely affect the long bone. The usual affected site in the long bone is tibia and fibula. Ossifying fibroma has a moderate tendency to progress during childhood and ceases to progress after puberty. So, surgery should be delayed as long as possible. But if the lesion is wide, which may cause pathologic fracture or severe deformity, it would be necessary to resect the lesion and restore the alignment. We have experienced 10 cases of ossifying fibroma which were treated at Department of Orthopaedic Surgery, Yonsei University College of Medicine, from Jan. 1984 to Nov. 1992. Results were.as follows: l. Among 10 cases, female was 5 cases and male was 5 cases. Age at operation was 9 years 1 month in average ranging from 1 year 7 months to 18 years 6 months. 2. The lesion site was 9 cases in the tibia, 1 case in the fibula. 3. Attended type of treatment was 3 cases of bone biopsy and observation, 1 case of curettage and bone graft, 1 case of curettage, external fixation with Ilizarov apparatus and internal transportation, 1 case of resection with curettage and free vascularized fibular graft, and 4 cases of wide resection and free vascularized fibula graft. 4. Second operation was needed in 2 cases due to recurrence which were performed incomplete wide resection. In conclusion, continuous observation is needed until puberty when the lesion ceases to progress in ossifying fibroma but radical surgery like wide resection and free vascularized fibula transfer is needed if there is a risk of pathologic fracture or severe bowing deformity due to its large size.