Surgical treatment for shepherd's crook deformity in fibrous dysplasia: THERE IS NO BEST, ONLY BETTER.

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Abstract

[Indexed for MEDLINE] 5. J Orthop Case Rep. 2024 Feb;14(2):155-159. doi: 10.13107/jocr.2024.v14.i02.4254. A Closer Look at Fibrous Dysplasia Femur Fracture Five-year Follow-up: A Unique Case. Sauhta R(1), Makkar D(2). Author information: (1)Department of Orthopaedics, Artemis Hospital and NC Medical College, Panipat, Haryana, India. (2)Department of Orthopaedics, NC Medical College, Panipat, Haryana, India. INTRODUCTION: Fibrous dysplasia (FD) is a benign skeletal disorder characterized by the replacement of normal bone tissue with disorganized fibrous tissue. Fractures are a significant complication of FD, particularly in the proximal femur, where deformities such as Shepherd's crook deformity can increase the risk. CASE REPORT: We present a case study of a 44-year-old male with unilateral monostotic FD, Shepherd's crook deformity, and a pathological femoral shaft fracture. The initial surgical approach involved valgus osteotomy, dynamic condylar screw (DCS) fixation, and multiple osteotomies of the femoral shaft. However, the patient experienced a refracture and implant failure, necessitating a second surgical intervention with a double-angled DCS and additional fixation. Post-operative follow-up revealed successful bone union and deformity correction, although a limb length discrepancy was noted. CONCLUSION: This case highlights the challenges in managing FD-related fractures and the importance of addressing deformities and achieving optimal alignment. Individualized treatment approaches, careful implant selection, and post-operative rehabilitation are crucial for successful outcomes in FD-associated fractures. Copyright: © Indian Orthopaedic Research Group. DOI: 10.13107/jocr.2024.v14.i02.4254 PMCID: PMC10898715