(Disclaimer: This article is for scientific purposes only. To protect patient privacy, the information in the following content has been processed.) Abstract: Osteofibrous dysplasia is commonly seen in adolescents and children. In this paper, an 18-year-old male patient complained of thigh pain that worsened with activity and could be relieved by rest. Through ancillary examinations and medical history, it was highly suspected of osteofibrous dysplasia, and the patient was recommended to undergo surgical treatment with scraping of the lesion and bone grafting + internal fixation. The pain in the thigh was significantly relieved after the operation, and the patient could completely abandon the crutches and walk 6 months after the operation. The patient was treated with surgery (focal scraping and bone grafting surgery + internal fixation surgery) in January 2022. A senior high school student who had right thigh pain before. The patient complained of thigh pain for 3 months, which was deep swelling and pain that worsened with activity, but could be partially relieved with rest. The pain is partially relieved when resting, and when the pain is severe, he takes some painkillers, which have some effect. He usually does not exercise much and has not suffered any trauma recently, and has no fever. After the initial consultation, a detailed physical examination was performed. The patient had no obvious deformity, swelling or redness in the thigh, and the skin temperature was normal, but there was pain in the deep part when pressure was applied. The patient was so young and presented with persistent pain in the thigh that femoral lesions were first suspected. A femoral X-ray was performed to clarify the diagnosis, and it was obvious from the film that there was a ground glass-like lesion in the proximal end of the right femur, but the diagnosis could not be confirmed from the film. After the patient was admitted to the hospital, further MRI was performed, which showed abnormal intramedullary signals in both the femoral neck and the trochanter. The MRI results showed a high degree of suspicion of fibrous dysplasia, but the final diagnosis needed to be made by pathology, which is the gold standard for diagnosis. After communicating with the patient and his family about his condition and treatment plan, the patient finally received surgical treatment of lesion scraping and bone grafting + internal fixation, and the lesion was completely scraped and implanted with autologous iliac bone. The patient’s thigh pain was significantly relieved after the surgery, and he was discharged from the hospital 2 weeks after the surgery. After discharge, the patient was regularly reviewed in the outpatient clinic and was able to walk with crutches within 6 weeks after surgery. At 3 months postoperatively, the patient could basically walk with weight on crutches and had no local discomfort in the thigh. At 6 months after surgery, the patient could abandon the crutches completely. About 1 year after surgery, after the bone is completely healed, the internal fixation can be removed. After surgery to scrape out the lesion, the bone strength will be further reduced, so the patient often needs auxiliary internal fixation protection to avoid postoperative fracture. Postoperative crutches are often required for a period of time, depending on the extent of the lesion removal. In addition, although dyskeratosis is a benign lesion that is rarely malignant, patients need to be reviewed about once every six months after surgery. I am very happy for the patient that his discomfort was relieved after the surgery and that he had a good result. V. Personal insight Bone fibrous dysplasia is a benign tumor, so even if it is found, it is not necessary to be overly nervous. The most common clinical type is monostyle, and this patient belongs to this type. For asymptomatic dysplasia, no special treatment is needed after detection, and regular observation is sufficient. However, if the lesion is large and painful or causes pathological fracture, scraping and implantation with the aid of an internal fixation plate if necessary may be an option. The disease has a certain chance of recurrence after surgical excision, so regular postoperative review is required.