Acquired Spur-Like Bony Growth Over the Previous Fibulectomy Site Following the Management of Both Bone Leg Fracture Nonunion: A Case Report

Abstract

Abstract Exophytic bony outgrowths have many differential diagnoses, with osteochondroma being the most common. The de novo development of a well-defined bony growth over the location of a previous surgery is a rare occurrence. Here, we describe a case of gradual development of a small bony exophytic lesion over the fibula diaphysis as a delayed complication of the previous fibulectomy. The index surgical procedure of fibulectomy was coupled with bone grafting at the tibial nonunion site following failed conservative management of the tibia fracture. The tibia fracture eventually united after the bone graft procedure. However, there was a gradual development of the aforementioned bony outgrowth noted in serial radiographs at the site of the previous fibulectomy. The growing lesion was also palpable on deep palpation over the corresponding site, and the excision of the lesion revealed a solid bony mass. Histopathology showed the lesion to be composed of mature bony tissue without any evidence of a cartilage cap. No recurrence or complication was noted in the fourteen-month follow-up. The diagnosis of an acquired exostosis was established based on clinical, radiological, and histopathological evaluation.