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Fibrous dysplasia, shepherd’s crook deformity and an intra-capsular femoral neck fracture

Fibrous dysplasia (FD) is a rare bone disorder in which normal medullary bone is replaced by fibro-osseous tissue. It typically presents in childhood with pain, skeletal deformities, gait abnormalities and occasionally, fatigue fractures. The management of FD remains a challenge. Surgical procedures...

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Autores principales: Al-Mouazzen, Louay, Rajakulendran, Karthig, Ahad, Nurul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Milan 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800513/
https://www.ncbi.nlm.nih.gov/pubmed/24036944
http://dx.doi.org/10.1007/s11751-013-0174-7
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author Al-Mouazzen, Louay
Rajakulendran, Karthig
Ahad, Nurul
author_facet Al-Mouazzen, Louay
Rajakulendran, Karthig
Ahad, Nurul
author_sort Al-Mouazzen, Louay
collection PubMed
description Fibrous dysplasia (FD) is a rare bone disorder in which normal medullary bone is replaced by fibro-osseous tissue. It typically presents in childhood with pain, skeletal deformities, gait abnormalities and occasionally, fatigue fractures. The management of FD remains a challenge. Surgical procedures have been developed to provide symptom relief, correct skeletal deformity and offer mechanical support in cases at risk of fracture. However, there is a paucity of data on the management of acute femoral neck fractures in the adult population with FD. We report the case of a 23-year-old man with a shepherd’s crook deformity secondary to FD, who sustained an intra-capsular femoral neck fracture whilst playing football. The patient initially underwent closed reduction and internal fixation with cannulated screws. However, during the procedure, a guide wire broke whilst inside the femoral head. The patient was referred to the senior author, who undertook a second operation to remove the metalwork and correct the varus deformity using a closing-wedge femoral osteotomy, whilst achieving osteosynthesis at the fracture site. At 1-year follow-up, the patient is pain-free and demonstrates a full range of movement. These cases can be technically demanding and carry a greater risk of complication. It is important that preoperative planning is undertaken and surgery performed by individuals with experience in managing FD and complex femoral neck fractures. Correction of the skeletal deformity whilst fixing the fracture will help restore the mechanical axis and reduce the risk of a recurrent fracture.
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spelling pubmed-38005132013-10-29 Fibrous dysplasia, shepherd’s crook deformity and an intra-capsular femoral neck fracture Al-Mouazzen, Louay Rajakulendran, Karthig Ahad, Nurul Strategies Trauma Limb Reconstr Case Report Fibrous dysplasia (FD) is a rare bone disorder in which normal medullary bone is replaced by fibro-osseous tissue. It typically presents in childhood with pain, skeletal deformities, gait abnormalities and occasionally, fatigue fractures. The management of FD remains a challenge. Surgical procedures have been developed to provide symptom relief, correct skeletal deformity and offer mechanical support in cases at risk of fracture. However, there is a paucity of data on the management of acute femoral neck fractures in the adult population with FD. We report the case of a 23-year-old man with a shepherd’s crook deformity secondary to FD, who sustained an intra-capsular femoral neck fracture whilst playing football. The patient initially underwent closed reduction and internal fixation with cannulated screws. However, during the procedure, a guide wire broke whilst inside the femoral head. The patient was referred to the senior author, who undertook a second operation to remove the metalwork and correct the varus deformity using a closing-wedge femoral osteotomy, whilst achieving osteosynthesis at the fracture site. At 1-year follow-up, the patient is pain-free and demonstrates a full range of movement. These cases can be technically demanding and carry a greater risk of complication. It is important that preoperative planning is undertaken and surgery performed by individuals with experience in managing FD and complex femoral neck fractures. Correction of the skeletal deformity whilst fixing the fracture will help restore the mechanical axis and reduce the risk of a recurrent fracture. Springer Milan 2013-09-14 2013-11 /pmc/articles/PMC3800513/ /pubmed/24036944 http://dx.doi.org/10.1007/s11751-013-0174-7 Text en © The Author(s) 2013 https://creativecommons.org/licenses/by/2.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Case Report
Al-Mouazzen, Louay
Rajakulendran, Karthig
Ahad, Nurul
Fibrous dysplasia, shepherd’s crook deformity and an intra-capsular femoral neck fracture
title Fibrous dysplasia, shepherd’s crook deformity and an intra-capsular femoral neck fracture
title_full Fibrous dysplasia, shepherd’s crook deformity and an intra-capsular femoral neck fracture
title_fullStr Fibrous dysplasia, shepherd’s crook deformity and an intra-capsular femoral neck fracture
title_full_unstemmed Fibrous dysplasia, shepherd’s crook deformity and an intra-capsular femoral neck fracture
title_short Fibrous dysplasia, shepherd’s crook deformity and an intra-capsular femoral neck fracture
title_sort fibrous dysplasia, shepherd’s crook deformity and an intra-capsular femoral neck fracture
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3800513/
https://www.ncbi.nlm.nih.gov/pubmed/24036944
http://dx.doi.org/10.1007/s11751-013-0174-7
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