Pathologic Fracture: A Rare
Situation In Children.
Pilotto C, Robazza M, Vergine M, Passone E.
Clinica Pediatrica, Azienda Ospedaliero Universitaria Santa Maria
Della Misericordia, Udine.
RX tibia dx
RMN T1Fs sag
Introduction
Pathological fracture is a rare condition in the paediatric patient. It should be suspected if the
fracture involves an unusual district or if it is associated with minimal trauma.
Case report
An 11 years-old girl presented a spiroid fracture of the tibia, after an ankle sprain occurred
during low-intensity sport activity. Leg X-ray showed a 5 cm multi-loculated radiolucent area
surrounded by a thin corticalization layer associated with the fracture. A conservative treatment
was initially chosenwithclosed reduction of the fracture and immobilization. An MRI showed a
lesion with an hypointense signal on T1-weigthed sequences and a dishomogenous hyperintense
signal onT2-weigthed images, with typical marrow oedema surrounded by haemorrage
secondary to the fracture. The imaging was consistent with non-ossifying fibroma. As the child
suffered from a consolidation delay, after 3 months she was treated with curettage and bone
grafting.
Discussion
The non-ossifying fibroma (NOF)is the most common benign bone lesion in children. It is estimated
between 30% and 40% of people <20 years of age. Usually it is asymptomatic and can be
monitored without intervention. NOF should be treated only if it interferes with the bone healing
process.
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