Abstract
Pathological fractures and so-called shepherd's crook deformity of the proximal femur are serious problems in patients with fibrous dysplasia. We treated 4 such patients who had proximal femoral fractures (1 man and 3 women, mean age 15.5 years, 1 monostotic type and 3 polyostotic types) between 1985 and 2005. The mean follow-up period was 8 years. The fractures united in all patients, but varus deformity of the hip worsened in two patients after surgery. In one male patient with a monostotic fracture, the femoral neck angle did not change and the tumor enlarged.
In one female patient with a polyostotic fracture, although the femoral neck angle did not change, osteoarthritis of the hip developed. We considered that osteosynthesis with plates or intramedullary nails was useful for these fractures. However, as osteosynthesis is sometimes impossible in patients with severe varus deformity of the hip, valgus osteotomy with external skeletal fixation might be useful for such patients.
