Use of a retrograde femoral nail in a patient with McCune-Albright syndrome.
McCune-Albright Syndrome is a rare condition characterized by endocrine abnormalities, precocious puberty, pigmented skin lesions and polyostotic fibrous dysplasia with consequent fractures and limb deformity. Patients with this syndrome might have had multiple operations on a limb and might also have extensive internal fixation in-situ. We review the case of a 41-year-old woman with McCune-Albright syndrome, who presented with a pathological fracture of her left femur below a long plate and screws. Our management of this challenging problem included the use of a retrograde femoral nail, which, because of the need to retain pre-existing internal fixation, had to be locked proximally through a hole in a femoral plate. This technique, combined with reaming, and thus bone grafting of the fracture, and also perioperative infusions of pamidronate, allowed an early recovery and return to premorbid function for the patient. In the present study we detail our technique and discuss its advantages over other possible methods of treatment.
Garvan
John D
JD
Orthopaedic Department, The Sutherland Hospital, Caringbah, New South Wales, Australia.
Trantalis
John N
JN
D000328:Adult; D001858:Bone Nails; D004867:Equipment Design; D005260:Female; D005264:Femoral Fractures / Q000209:etiology / Q000601:surgery*; D005359:Fibrous Dysplasia, Polyostotic / Q000150:complications*; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D005598:Fractures, Spontaneous / Q000209:etiology / Q000601:surgery*; D006801:Humans