ABSTRACT
A 5 years old girl presented 3 years back with pain and swelling over the upper right leg for 2 years duration. X-ray, CT and MRI revealed osteolytic well defined lesion 2.5 × 2 cm in the meta-diaphyseal region of the proximal tibia with pathological fracture of anterolateral cortex. Child underwent thorough curettage of the lesion and the defect was filled with allograft (iliac crest graft) from mother which was harvested in an adjacent operation theatre. The limb was protected with a plaster splint for a period of 3 months. The graft gradually consolidated and new bone formation was apparent by 6 months. Remodelling of the medullary canal occurred at 1 year follow up. Child has been followed up to 3 years (till date) and there is no evidence of recurrence. The case illustrates that osteofibrous dyplasia can be effectively treated by curettage and replacement of defect by allograft from parents.