» Articles » PMID: 38420235

A Closer Look at Fibrous Dysplasia Femur Fracture Five-year Follow-up: A Unique Case

Overview
Specialty Orthopedics
Date 2024 Feb 29
PMID 38420235
Authors
Affiliations
Soon will be listed here.
Abstract

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.

References
1.
Wang Y, Luo Y, Min L, Zhou Y, Wang J, Zhang Y . The West China Hospital radiographic classification for fibrous dysplasia in femur and adjacent bones: A retrospective analysis of 205 patients. Orthop Surg. 2022; 14(9):2096-2108. PMC: 9483050. DOI: 10.1111/os.13404. View

2.
Dheenadhayalan J, Avinash M, Lakhani A, Rajasekaran S . Shepherd's crook deformity: How to set it straight. A five-step surgical guide. J Orthop Surg (Hong Kong). 2019; 27(1):2309499019834362. DOI: 10.1177/2309499019834362. View

3.
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

4.
Abulsaad M, Abdelrahman A . Modified Sofield-Millar operation: less invasive surgery of lower limbs in osteogenesis imperfecta. Int Orthop. 2008; 33(2):527-32. PMC: 2899078. DOI: 10.1007/s00264-008-0515-1. View

5.
Riminucci M, Liu B, Corsi A, Shenker A, Spiegel A, Robey P . The histopathology of fibrous dysplasia of bone in patients with activating mutations of the Gs alpha gene: site-specific patterns and recurrent histological hallmarks. J Pathol. 1999; 187(2):249-58. DOI: 10.1002/(SICI)1096-9896(199901)187:2<249::AID-PATH222>3.0.CO;2-J. View