Published online Mar 18, 2022. doi: 10.5312/wjo.v13.i3.329
Peer-review started: March 15, 2021
First decision: October 17, 2021
Revised: October 25, 2021
Accepted: February 15, 2022
Article in press: February 15, 2022
Published online: March 18, 2022
Processing time: 366 Days and 23.9 Hours
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. Different surgical fixation devices have been described in the past.
No common consensus on the optimal surgical treatment for this pathology among orthopedic surgeons is present.
The aim of our study was to identify the correct indications for surgical treatment of femoral deformities in patients with PDF and MAS, the effectiveness over time of the different corrective osteotomies performed and the best devices to better stabilize the fibrodysplastic bone.
A review of English language literature from 1987 until now was performed following the population, intervention, comparator, outcome guidelines.
Fifteen articles were included for qualitative synthesis in the study after the initial screening resulted in 184 papers.
Correction of coxa vara and shepherd’s crook deformity remains a demanding procedure and, especially in severe cases, more than one operation is necessary. Intramedullary nailing is often preferred to stabilize osteotomies performed in fibrodysplastic bone, while peripheral plating remains the device of choice to stabilize osteotomies performed for coxa vara.
High-quality prospective randomized clinical trials are needed.