Surgical treatment of fibrous dysplasia of bone involving the femur with severe varus deformity / 中国矫形外科杂志

ABSTRACT

[Objective]To find an effective method of surgical treatment of fibrous dysplasia of bone involving the femur associated with severe varus deformity.[Method]Thirteen patients with fibrous dysplasia of bone involving 14 femurs with severe varus deformity were reviewed from Feb 2002 and Jul 2005.Medial displacement of valgus or valgus osteotomies,curettage and allograft,reconstructional nail have been adolted to treat fibrous dysplasia of bone involving the femur with severe varus deformity.[Result]All patients were followed up from 8 months to 41 months with an average of 21 months.Forteen femoral mechanical alignments(axis)had been corrected completely rdiologically;the preoperative average neck-shaft angle of 75?(range,55?~100?),corrected to the average 120?(range,95 ?~135?)of postoperative,the average shortening of the femur was 3.4 cm(range,2.0~4.5 cm)preoperatively,then enlongthened by 2.8 cm(range,1.8~3.6 cm)in postoperation.Ninteen location of osteotomies showed good union in 14 femur.All bone grafts were absorbed slightly beginning at 3 months and markedly at 10 to 14 months postoperatively.Preoperation,4 patients walked with bilateral crutches,2 used unilateral cane,5 can't walk due to pathological fracture,2 without support;after operation,11 patients walk without support,2 ambulated with the aid of unilateracane.Eleven patients were painless,2 moderate pain.All had no infections and recurrent fracture and progression of the deformity.[Conclusion](1)This method can correct varus deformity,improve function,as well as restore biomechanical axis of femur.(2)It is able to effectively eradicate lesions and prevent recurrence.(3)Impaction allograft is the key of prompting allograft incorporating fully and preventing pathological fracture.