Double-level Osteotomy and One-stage Reconstruction with Long Intramedullary Femoral Nail to Correct a Severe Proximal and Diaphyseal Femur Deformity in a Patient with Polyostotic Fibrous Dysplasia: Case Report and Literatures Review

Overview

Journal Int J Clin Exp Med

Specialty General Medicine

Date 2015 Nov 10

PMID 26550394

Citations 5

Authors

Feiyan Chen

Yibing Wei

Jun Xia

Jianguo Wu

Siqun Wang

Gangyong Huang

Jie Chen

Jingsheng Shi

Affiliations

Soon will be listed here.

Abstract

Proximal femur is often involved with varus and retroversion deformity in polyostotic fibrous dysplasia (PFD). Multiple corrective osteotomies with intramedullary nails in two stages is recommended procedure as some authors described. We report a case using double-level osteotomy and one-stage reconstruction with intramedullary nail in a patient with painful proximal femur and diaphysis varus deformity, the neck-shaft angle was corrected from 95° pre-operatively to 125° post-operatively, the patient was free of pain and no evidence of recurrence at the 24-month follow up. The operative design and method were described, and a review of related literatures about the treatment alteration for PFD and relevant operative selection were also performed.

Citing Articles

Lower-limb intramedullary nailing in patients with polyostotic fibrous dysplasia who had a previous unsuccessful treatment. A report of 48 cases.

Ippolito E, Farsetti P, Caterini R, Gorgolini G, Caterini A, De Maio F J Orthop Traumatol. 2023; 24(1):35.

PMID: 37402946 PMC: 10319686. DOI: 10.1186/s10195-023-00705-7.

The West China Hospital radiographic classification for fibrous dysplasia in femur and adjacent bones: A retrospective analysis of 205 patients.

Wang Y, Luo Y, Min L, Zhou Y, Wang J, Zhang Y Orthop Surg. 2022; 14(9):2096-2108.

PMID: 35924702 PMC: 9483050. DOI: 10.1111/os.13404.

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

Yang Q, Liu J, Tan L, Jiang Y, Zhu D Front Surg. 2022; 9:879550.

PMID: 35495762 PMC: 9039455. DOI: 10.3389/fsurg.2022.879550.

Surgical treatment of femoral deformities in polyostotic fibrous dysplasia and McCune-Albright syndrome: A literature review.

Gorgolini G, Caterini A, Nicotra L, De Maio F, Efremov K, Farsetti P World J Orthop. 2022; 13(3):329-338.

PMID: 35317251 PMC: 8935334. DOI: 10.5312/wjo.v13.i3.329.

McCune Albright syndrome - association of fibrous dysplasia, café-au-lait skin spots and hyperthyroidism - case report.

Raus I, Coroiu R Clujul Med. 2016; 89(4):559-564.

PMID: 27857528 PMC: 5111499. DOI: 10.15386/cjmed-624.

References

Freeman B, Bray 3rd E, MEYER L . Multiple osteotomies with Zickel nail fixation for polyostotic fibrous dysplasia involving the proximal part of the femur. J Bone Joint Surg Am. 1987; 69(5):691-8. View

Parisi M, Oliveri B, Mautalen C . Effect of intravenous pamidronate on bone markers and local bone mineral density in fibrous dysplasia. Bone. 2003; 33(4):582-8. DOI: 10.1016/s8756-3282(03)00221-7. View

DiCaprio M, Enneking W . Fibrous dysplasia. Pathophysiology, evaluation, and treatment. J Bone Joint Surg Am. 2005; 87(8):1848-64. DOI: 10.2106/JBJS.D.02942. View

Chen W, Chen W, Chiang C, Huang C, Chen T, Lo W . Shepherd's crook deformity of polyostotic fibrous dysplasia treated with corrective osteotomy and dynamic hip screw. J Chin Med Assoc. 2005; 68(7):343-6. DOI: 10.1016/S1726-4901(09)70173-X. View

Yamamoto T, Hashimoto Y, Mizuno K . Oblique wedge osteotomy for femoral diaphyseal deformity in fibrous dysplasia: a case report. Clin Orthop Relat Res. 2001; (384):245-9. DOI: 10.1097/00003086-200103000-00029. View

Keijser L, van Tienen T, Schreuder H, Lemmens J, Pruszczynski M, Veth R . Fibrous dysplasia of bone: management and outcome of 20 cases. J Surg Oncol. 2001; 76(3):157-66; discussion 167-8. DOI: 10.1002/jso.1028. View

Harris W, DUDLEY Jr H, Barry R . The natural history of fibrous dysplasia. An orthopaedic, pathological, and roentgenographic study. J Bone Joint Surg Am. 1962; 44-A:207-33. View

Nakashima Y, Kotoura Y, Nagashima T, Yamamuro T, Hamashima Y . Monostotic fibrous dysplasia in the femoral neck. A clinicopathologic study. Clin Orthop Relat Res. 1984; (191):242-8. View

Weinstein L . G(s)alpha mutations in fibrous dysplasia and McCune-Albright syndrome. J Bone Miner Res. 2007; 21 Suppl 2:P120-4. DOI: 10.1359/jbmr.06s223. View

10.

OSullivan M, Zacharin M . Intramedullary rodding and bisphosphonate treatment of polyostotic fibrous dysplasia associated with the McCune-Albright syndrome. J Pediatr Orthop. 2002; 22(2):255-60. View

11.

Weinstein L, Chen M, Liu J . Gs(alpha) mutations and imprinting defects in human disease. Ann N Y Acad Sci. 2002; 968:173-97. DOI: 10.1111/j.1749-6632.2002.tb04335.x. View

12.

Kataria H, Sharma N, Kanojia R . 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. J Orthop Surg (Hong Kong). 2009; 17(2):245-7. DOI: 10.1177/230949900901700229. View

13.

Riminucci M, Saggio I, Robey P, Bianco P . Fibrous dysplasia as a stem cell disease. J Bone Miner Res. 2007; 21 Suppl 2:P125-31. DOI: 10.1359/jbmr.06s224. View

14.

Stanton R . Surgery for fibrous dysplasia. J Bone Miner Res. 2007; 21 Suppl 2:P105-9. DOI: 10.1359/jbmr.06s220. View

15.

Guille J, Kumar S, MacEwen G . Fibrous dysplasia of the proximal part of the femur. Long-term results of curettage and bone-grafting and mechanical realignment. J Bone Joint Surg Am. 1998; 80(5):648-58. DOI: 10.2106/00004623-199805000-00005. View

16.

Glorieux F, Rauch F . Medical therapy of children with fibrous dysplasia. J Bone Miner Res. 2007; 21 Suppl 2:P110-3. DOI: 10.1359/jbmr.06s221. View

17.

ENNEKING W, Gearen P . Fibrous dysplasia of the femoral neck. Treatment by cortical bone-grafting. J Bone Joint Surg Am. 1986; 68(9):1415-22. View

18.

Sakurakichi K, Tsuchiya H, Yamashiro T, Watanabe K, Matsubara H, Tomita K . Ilizarov technique for correction of the Shepherd's crook deformity: a report of two cases. J Orthop Surg (Hong Kong). 2008; 16(2):254-6. DOI: 10.1177/230949900801600226. View

19.

Egner-Hobarth S, Welkerling H, Windhager R . [Bisphosphonates in the therapy of fibrous dysplasia. Relevant data and practical aspects]. Orthopade. 2007; 36(2):124, 126-30. DOI: 10.1007/s00132-007-1046-y. View

20.

Connolly J . Shepherd's Crook deformities of polyostotic fibrous dysplasia treated by osteotomy and Zickel nail fixation. Clin Orthop Relat Res. 1977; (123):22-4. View