Radiographic classification of coronal plane femoral deformities in polyostotic fibrous dysplasia.

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Abstract

[Indexed for MEDLINE] 15. Zhongguo Gu Shang. 2011 Apr;24(4):345-8. [Surgical treatment of fibrous dysplasia in proximal femur]. [Article in Chinese] Tong ZC(1), Wang KZ, Jiao N, Yang TM, Zhang W, Chen B. Author information: (1)Department of Osteopathia, Xi 'an Red Cross Hospital, Xi'an 710054, Shaanxi, China. zhichaotong@126.com OBJECTIVE: To summarize the oncological and functional results of patients with fibrous dysplasia in the proximal femur and explore its clinical effect. METHODS: From Apr. 2007 to Jan. 2009, 15 patients with fibrous dysplasia in proximal femur were treated. There were 9 males and 6 females, ranging in age from 16 to 32 years with an average of 25 years. The course of disease was from 2 months to 16 years with an average of 2 years. Among them, 12 cases were unilateral affection and 3 cases were hibateral affections; 12 cases were one bone and 3 cases more than two bones. The collodiaphyseal angles of 2 cases with coxa adducta was 80 degrees and 100 degrees respectively; and femur lengths were shorter than opposite side (5 cm and 3 cm, respectively). The curettage and allogenous and/or autogenous bone-grafting combined with internal fixation were performed in all patients and valgus osteotomies was performed in 2 case with shepherd's crook deformity. RESULTS: All patients were followed up from 12 to 32 months. Two cases with shepherd's crook deformity, the collodiaphyseal angles recovered after surgery, the relative length of femur was increased 4 cm and 3 cm respectively and they can walk with stick at 4 months after operation. No found recurrence and loosening of internal fixation. Bone graft was absorbed at 3 months and bone healing at 8-12 months after operation. The pain vanished and functions were normal. CONCLUSION: It is an effective method to treat fibrous dysplasia in proximal femur with curettage and bone-grafting combined with internal fixation. Corrective osteotomy and internal fixation with a dynamic hip screw is a good and effective method in treating severe symptomatic shepherd's crook deformity.