Polyostotic Fibrous Dysplasia Complicated by Pathological Fracture of Right Femoral Shaft with Nonunion: A Case Report.

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Abstract

Conflict of interest statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. 10. Acta Orthop. 2006 Jun;77(3):469-73. doi: 10.1080/17453670610046415. Multiple osteotomies and intramedullary nailing with neck cross-pinning for shepherd's crook deformity in polyostotic fibrous dysplasia: 7 femurs with a minimum of 2 years follow-up. Jung ST(1), Chung JY, Seo HY, Bae BH, Lim KY. Author information: (1)Department of Orthopedic Surgery, Chonnam National University Hospital, Kwangju, 501-757, Korea. stjung@chonnam.ac.kr BACKGROUND: In polyostotic fibrous dysplasia, particularly in lesions of the proximal femur, pathological fracture and coxa vara deformity (including shepherd's crook deformity) are likely to develop and progress. PATIENTS AND METHODS: In 7 femurs with shepherd's crook deformity (5 patients), we performed intramedullary nailing by using multiple osteotomies and two screws crossing the femoral neck. RESULTS: Restoration of the neck shaft angle of the femur was obtained from an average of 92 degrees prior to surgery to 129 degrees after surgery. During the minimum 2-year follow up, no loss of neck shaft angle of the femur and no refracture occurred. All patients were able to return to normal activities of daily living. INTERPRETATION: In polyostotic fibrous dysplasia, multiple osteotomies and intramedullary nailing with neck cross-pinning can be used to correct developed or progressing shepherd's crook deformity, and to prevent recurrence and refracture. DOI: 10.1080/17453670610046415