A Case Report of Bilateral Shepherd Crook Deformity of Proximal Femur in an Adolescent Managed by Corrective Osteotomy, Double Angle Blade Plate and Bone Graft.

Abstract

Introduction: Fibrous dysplasia (FD) is a benign, non-heritable, intramedullary fibro-osseous lesion described by Lichtenstein in 1938. It is considered that a developmental failure occurs during remodeling of woven bone so that lamellar bone fails to form. The bone also fails to remodel in response to mechanical stress. It has a considerable risk of pathological fractures particularly in proximal femur in younger age group. These are challenging to treat, especially in younger population. Several treatment modalities have been proposed, each having its own pros and cons. Attention should be given in pediatric population in choosing technique and selection of implants to preserve growth of the limb and to prevent implant prominence and soft-tissue irritation.

Case report: We are reporting a case of pathological proximal shaft of femur fracture secondary to FD, in an 14-year-old obese boy, managed with corrective osteotomy, 135° angle blade plate fixation and bone graft.

Conclusion: At subsequent follow-ups, he showed good consolidation at fracture site, stable implant, and an excellent functional outcome in terms of pain and range of motion, without any radiological sign of recurrence.