Systematic Reviews
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World J Orthop. Mar 18, 2022; 13(3): 329-338
Published online Mar 18, 2022. doi: 10.5312/wjo.v13.i3.329
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
Giulio Gorgolini, Alessandro Caterini, Lorenzo Nicotra, Fernando De Maio, Kristian Efremov, Pasquale Farsetti, Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Section of Orthopaedics and Traumatology, Tor Vergata Hospital, Rome 00133, Italy
Author contributions: Gorgolini G and Farsetti P designed the study and contributed to manuscript preparation and editing; Caterini A, De Maio F, and Efremov K equally contributed to data analysis and manuscript preparation; Nicotra L contributed to data collection and manuscript preparation.
Conflict-of-interest statement: The authors did not receive any funding or financial support or potential sources of conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pasquale Farsetti, MD, Professor, Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Section of Orthopaedics and Traumatology, Tor Vergata Hospital, Viale Oxford n. 81, Rome 00133, Italy. farsetti@uniroma2.it
Received: March 15, 2021
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
ARTICLE HIGHLIGHTS
Research 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. Different surgical fixation devices have been described in the past.

Research motivation

No common consensus on the optimal surgical treatment for this pathology among orthopedic surgeons is present.

Research objectives

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.

Research methods

A review of English language literature from 1987 until now was performed following the population, intervention, comparator, outcome guidelines.

Research results

Fifteen articles were included for qualitative synthesis in the study after the initial screening resulted in 184 papers.

Research conclusions

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.

Research perspectives

High-quality prospective randomized clinical trials are needed.