Management of Shepherd’s Crook Deformity by Proximal Femoral Osteotomy without Bone Graft - A Case Report
Avijit Basak, Kunal Mondal*, Pinaki Das, Raunak Agarwal and Subhasish Manna
Department of Orthopaedics, Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karni Memorial Hospital, West Bengal, India
*Corresponding Author: Kunal Mondal, Department of Orthopaedics, Institute of Post Graduate Medical Education and Research and Seth Sukhlal Karni Memorial Hospital, West Bengal, India.
Received:
November 01,2021; Published: December 14, 2021
Abstract
Introduction: Fibrous dysplasia is a benign condition of the skeletal system. In this disorder there is fibro-osseous proliferation with intervening areas of normal or immature bone in the intramedullary region. This is a case report reflecting management a case of unilateral shepherd’s crook deformity at right proximal femur with microfractures causing functional restrictions.
Case Report: A 19-year-old female presented with pain and shortening of right lower limb. Radiographs and histopathology suggestive of fibrous dysplasia. On the right side, we did a valgus close wedged osteotomy in the subtrochanteric region and fixed with dynamic condylar screw supported by 95-degree barrel plate without introducing any bone graft. Patient was followed up for 1 year and ends up with a better functional outcome evaluated by Harris hip score and Oxford hip score.
Conclusion: Lateral close wedged osteotomy is effective method to correct the shepherd’s crook deformity if properly executed. Hence using an extramedullary device without bone graft can be the choice of treatment in such cases.
Keywords: Fibrous Dysplasia; Shepherd’s Crook Deformity; Lateral Close Wedged Osteotomy; Dynamic Condylar Screw; 95-Degree Barrel Plate; Extramedullary Device; Bone Graft
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