{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:24:11Z","timestamp":1791984251239,"version":"4.4.0"},"reference-count":27,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T00:00:00Z","timestamp":1753315200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Children's Orthopaedics"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>Monostotic fibrous dysplasia is a rare benign fibro-osseous disorder. Proximal femoral monostotic fibrous dysplasia is especially vulnerable to pathological fracture and deformation, requiring specific treatment strategies. Literature on pediatric proximal femoral monostotic fibrous dysplasias is sparse and without consensus. We present the largest observational cohort study on various treatment methods of pediatric proximal femoral monostotic fibrous dysplasia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Pediatric patients with proximal femoral monostotic fibrous dysplasia were included, from 10 academic hospitals for oncological orthopedics (2000\u20132021). Baseline characteristics, treatment strategies, and complications were assessed. Primary outcomes were failure rates, failure-free survival, and risk factors for failure. Failure was defined as fracture, progressive deformity, or surgical (re-)intervention after the start of treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Forty-one pediatric patients with proximal femoral monostotic fibrous dysplasia were included (median age\u2009=\u200911\u2009years (range\u2009=\u20096\u201316),\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921 (51%) male). Median follow-up was 5.1\u2009years (range\u2009=\u20090.8\u201318.6). Index procedure was watchful waiting (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20099), percutaneous procedure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20094), open procedure (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915), or internal fixation (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200913). Failure rates were 11%, 50%, 40%, and 31%, respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.41). Overall, 2- and 5-year failure-free survival was stable at 87.5% (95% confidence interval\u2009=\u200964.6\u2013110.4). Risk factors associated with failure were fracture at diagnosis (hazard ratio\u2009=\u20093.7, 95% confidence interval\u2009=\u20091.2\u201311.5), calcar involvement (hazard ratio\u2009=\u20092.6, 95% confidence interval\u2009=\u20090.7\u20139.4), and male sex (hazard ratio\u2009=\u20092.1, 95% confidence interval\u2009=\u20090.6\u20137.8).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>In cases with low fracture and deformity risk, watchful waiting can be a viable management option for proximal femoral monostotic fibrous dysplasia. When intervention is necessary, internal fixation is advised to prevent fractures and deformity. Curettage with grafting or bone substitute injections should be used with hesitance. Currently, there is no clearly superior treatment for pediatric proximal femoral monostotic fibrous dysplasia, leaving treatment choices to be based on individual characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/18632521251355884","type":"journal-article","created":{"date-parts":[[2025,7,24]],"date-time":"2025-07-24T08:10:23Z","timestamp":1753344623000},"page":"367-376","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Surgical treatment of monostotic fibrous dysplasia of the proximal femur in children and adolescents: Observational European Paediatric Orthopaedic Society multicenter study"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7227-8843","authenticated-orcid":false,"given":"Thomas PG","family":"van Geloven","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter Bas","family":"de Witte","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Pediatric Orthopaedics, Erasmus MC Sophia Children Hospital, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minna K","family":"Laitinen","sequence":"additional","affiliation":[{"name":"Bone Tumor Unit, Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3912-3943","authenticated-orcid":false,"given":"Domenico A","family":"Campanacci","sequence":"additional","affiliation":[{"name":"Orthopedic Oncology and Reconstructive Surgery, Azienda Ospedaliero Universitaria Careggi, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5982-5750","authenticated-orcid":false,"given":"Kevin","family":"D\u00f6ring","sequence":"additional","affiliation":[{"name":"Division of Orthopedics, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dietmar","family":"Dammerer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Traumatology, University Hospital of Krems, Krems, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed K","family":"Mesregah","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Menoufia, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasja M","family":"Appelman-Dijkstra","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Department of Medicine, Centre for Bone Quality, Leiden University Medical Center, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikko","family":"Haara","sequence":"additional","affiliation":[{"name":"Bone Tumor Unit, Orthopedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"},{"name":"Pediatric Surgery and Orthopedics, New Children\u2019s Hospital Helsinki, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Beltrami","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics Department, Azienda Ospedaliero Universitaria IRCCS A. Meyer, Florence, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerhard M","family":"Hobusch","sequence":"additional","affiliation":[{"name":"Division of Orthopedics, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanja","family":"Kraus","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedic Unit, Orthopedics and Traumatology, Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Farr","sequence":"additional","affiliation":[{"name":"Pediatric Orthopedics and Foot and Ankle Surgery, Orthopedic Hospital Speising, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilo","family":"Soto-Montoya","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Instituto Nacional de Cancerologia, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6436-7341","authenticated-orcid":false,"given":"Manuel R","family":"Medellin Rincon","sequence":"additional","affiliation":[{"name":"Orthopaedic Oncology\/Sarcoma Unit, Fundacion CTIC Luis Carlos Sarmiento Angulo, Bogot\u00e1, Colombia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0893-0187","authenticated-orcid":false,"given":"Javeria","family":"Saeed","sequence":"additional","affiliation":[{"name":"Orthopedic Surgery, Aga Khan University Hospital, Karachi, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillipp T","family":"Funovics","sequence":"additional","affiliation":[{"name":"Division of Orthopedics, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizz","family":"van der Heijden","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Orthopaedic Department, Princes Maxima Centre for Pediatric Oncology, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiel AJ","family":"van de Sande","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands"},{"name":"Orthopaedic Department, Princes Maxima Centre for Pediatric Oncology, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,24]]},"reference":[{"key":"e_1_3_2_2_2","first-page":"472","volume-title":"WHO classification of tumours","author":"WHO Classification of Tumours Editorial Board","year":"2020","unstructured":"WHO Classification of Tumours Editorial Board. 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