Surgical treatment of femoral deformities in polyostotic fibrous dysplasia and McCune-Albright syndrome: A literature review

Giulio Gorgolini; Alessandro Caterini; Lorenzo Nicotra; Fernando De Maio; Kristian Efremov; Pasquale Farsetti

doi:10.5312/wjo.v13.i3.329

Surgical treatment of femoral deformities in polyostotic fibrous dysplasia and McCune-Albright syndrome: A literature review

World J Orthop. 2022 Mar 18;13(3):329-338. doi: 10.5312/wjo.v13.i3.329.

Authors

Giulio Gorgolini¹, Alessandro Caterini¹, Lorenzo Nicotra¹, Fernando De Maio¹, Kristian Efremov¹, Pasquale Farsetti²

Affiliations

¹ Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Section of Orthopaedics and Traumatology, Tor Vergata Hospital, Rome 00133, Italy.
² Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Section of Orthopaedics and Traumatology, Tor Vergata Hospital, Rome 00133, Italy. farsetti@uniroma2.it.

Abstract

Background: Surgical correction of femoral deformities in polyostotic fibrous dysplasia (PFD) or McCune-Albright syndrome (MAS), such as coxa vara or shepherd's crook deformity, is a challenge.

Aim: To evaluate the treatment of patients with femoral deformities caused by PDF or MAS treated by osteotomies and stabilized with different methods, by analyzing the most relevant studies on the topic.

Methods: A literature search was performed in Medline database (PubMed). Articles were screened for patients affected by PFD or MAS surgically managed by osteotomies and stabilized with different methods.

Results: The initial search produced 184 studies, with 15 fulfilling the eligibility criteria of our study. Selected articles (1987-2019) included 111 patients overall (136 femurs).

Conclusion: Based on our results, the preferred method to stabilize corrective osteotomies is intramedullary nailing with neck cross pinning. When the deformity is limited to the proximal part of the femur, a screw or blade plate may be used, although there is a high risk of fracture below the plate. When the femur is entirely involved, a two-stage procedure may be considered.

Keywords: Coxa vara; Femoral osteotomy; Intramedullary nailing; McCune-Albright syndrome; Polyostotic fibrous dysplasia; Shepherd’s crook deformity.