Treatment of shepherd's crook deformity in patients with polyostotic fibrous dysplasia using a new type of custom made retrograde intramedullary nail: a technical note.

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Abstract

12. Cureus. 2021 Jul 19;13(7):e16485. doi: 10.7759/cureus.16485. eCollection 2021 Jul. A Shepherd's Crook Deformity of Proximal Femur Treated by Valgus Osteotomy and Bone Grafting. Pathak SK(1), S M A(2), Thivari PS(1), Sharma AR(3), Chawla JS(1), Sharma A(1), Garg A(1), Sharma S(1), Ratna HVK(1), Singh A(1), Jain A(1). Author information: (1)Department of Orthopedics, Maharishi Markandeshwar (Deemed to be University), Ambala, IND. (2)Department of Orthopedics, Ramaiah Medical College and Hospitals, Bangalore, IND. (3)Department of Orthopedics, Government Medical College and Hospital, Chandigarh, IND. The Shepherd's crook deformity of the proximal femur is a characteristic radiologic feature of fibrous dysplasia. It may be limited to a single bone, which is called monostotic, or may be polyostotic involving multiple bones as seen in McCune-Albright Syndrome. We report a case of a 19-year-old male patient who presented to us with pain in the right hip for one year. He had dysmorphic facies and multiple café-au-lait spots over the back, which were suggestive of McCune-Albright Syndrome. The radiographs of the hip showed varus deformity of the proximal femur. A lateral closing wedge osteotomy was done and the defect was filled with morselised femoral head allografts and fibular strut allografts. At the 14-month follow-up, the patient remained functionally active without any symptoms. The use of morselised femoral head allograft combined with strut fibular allograft ensures both stability and improved biology at the site of the lesion without any donor site morbidity. Copyright © 2021, Pathak et al. DOI: 10.7759/cureus.16485 PMCID: PMC8372827