Free accessResearch articleFirst published online 2009-8
One-Stage Osteotomy and Fixation Using a Long Proximal Femoral Nail and Fibular Graft to Correct a Severe Shepherd's Crook Deformity in a Patient with Fibrous Dysplasia: A Case Report
We report a case where a one-stage osteotomy and fixation, using a long proximal femoral nail and fibular graft, was performed to correct a severe shepherd's crook deformity (70° varus and 50° retroversion) of the femoral neck with a pathological stress fracture in a patient with fibrous dysplasia. The neck shaft angle was corrected to 125°. At the 57-month follow-up, the patient was free of pain and had no limp or evidence of recurrence.
FreemanBHBrayEW3rdMeyerLC. Multiple osteotomies with Zickel nail fixation for polyostotic fibrous dysplasia involving the proximal part of the femur. J Bone Joint Surg Am1987;69:691–8.
2.
GuilleJTKumarSJMacEwenGD. Fibrous dysplasia of the proximal part of the femur. Long-term results of curettage and bone-grafting and mechanical realignment. J Bone Joint Surg Am1998;80:648–58.
3.
BreckLW. Treatment of fibrous dysplasia of bone by total femoral plating and hip nailing. A case report. Clin Orthop Relat Res1972;82:82–3.
4.
O'SullivanMZacharinM. Intramedullary rodding and bisphosphonate treatment of polyostotic fibrous dysplasia associated with the McCune-Albright syndrome. J Pediatr Orthop2002;22:255–60.
5.
JungSTChungJYSeoHYBaeBHLimKY. 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. Acta Orthop2006;77:469–73.
6.
EnnekingWFGearenPF. Fibrous dysplasia of femoral neck. Treatment by cortical bone-grafting. J Bone Joint Surg Am1986;68:1415–22.
7.
NagdaTVSinghHKandoiMSamantAPatelBR. Two stage reconstruction for the Shepherd's crook deformity in a case of polyostotic fibrous dysplasia. J Postgrad Med1997;43:83–4.