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.
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.


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.


CONCLUSIONS
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.
Jung
Sung-Taek
ST
Department of Orthopedic Surgery, Chonnam National University Hospital, Kwangju, 501-757, Korea. stjung@chonnam.ac.kr
Chung
Jae-Yoon
JY
Seo
Hyoung-Yeon
HY
Bae
Bong-Hyun
BH
Lim
Keun-Young
KY
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001858:Bone Nails; D001863:Bone Screws; D005260:Female; D005264:Femoral Fractures / Q000517:prevention & control; D005269:Femur / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery; D005272:Femur Neck / Q000601:surgery*; D005359:Fibrous Dysplasia, Polyostotic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D011859:Radiography; D016896:Treatment Outcome