Segmental multi-planar osteotomy and anatomic locking plate fixation for severe fibrous dysplasia of the proximal femur: a retrospective case series.

Authors

Mingyang Cao, Haipeng Li, Jun Li, Zhiyu Gao

Published in

Acta orthopaedica et traumatologica turcica. Volume 60. Issue 5. Oct 20, 2026. Epub Oct 20, 2026.

Abstract

This study aimed to evaluate the radiographic and clinical outcomes of segmental multi-planar osteotomy combined with proximal femoral anatomic locking plate (PF-ALP) fixation in patients with severe proximal femoral fibrous dysplasia.  Methods: A single-center retrospective review was conducted on consecutive patients with severe proximal femoral FD treated between January 2020 and December 2024. All included femora demonstrated symptomatic deformity with a neck-shaft angle (NSA) less than 90°. Alternative fixation strategies were selected considering femoral geometry. Preoperative planning incorporated geometric deformity analysis, including center of rotation of angulation (CORA) principles. Surgical reconstruction consisted of a proximal closing-wedge osteotomy combined, when indicated, with a transverse derotation osteotomy, followed by long-segment PF-ALP fixation. Outcomes were assessed using serial radiographs, measurements of radiographic functional limb shortening, and the Harris Hip Score (HHS). Descriptive statistics were applied.  Results: Eight patients (nine femora) completed a minimum follow-up of 12 months (mean, 26.8 months). Radiographic union was achieved in all treated femora, with one case demonstrating delayed consolidation. The mean NSA improved from 64.9° preoperatively (range, 45°-81°) to 121.4° (range, 114°-132°) at final follow-up. In unilateral cases, mean functional limb shortening decreased from 5.7 cm preoperatively to 0.9 cm at final follow-up. Functional outcomes improved consistently, with mean HHS increasing from 66.4 to 93.1.  Conclusion: In carefully selected patients with severe proximal femoral fibrous dysplasia and advanced shepherd's crook deformity, segmental multi-planar osteotomy with PF-ALP fixation provided satisfactory early to mid-term radiographic and functional outcomes. PF-ALP fixation may be a viable alternative when intramedullary fixation is not feasible. Longer follow-up is needed to confirm the durability of these results.    Cite this article as: Cao M, Li H, Li J, Gao Z. Segmental multi-planar osteotomy and anatomic locking plate fixation for severe fibrous dysplasia of the proximal femur: a retrospective case series. Acta Orthop Traumatol Turc. 2026; 60(5), 0865, doi: 10.5152/j.aott.2026.26865.

PMID:
43006168
Bibliographic data and abstract were imported from PubMed on 10 Nov 2026.

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