PMC9039455_01
X-ray of the patient on admission.
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F1
On admission, the clinical presentation was consistent with varus hip deformity, possibly with bilateral femoral neck deformities (Figure 1).
Preoperative external image.
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F2
Both lower extremities were deformed, and both knee joints were huge (Figure 2).
Preoperative CT.
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F3
In view of the abnormal bone quality of the patient, the imaging examination showed: multiple fibrous dysplasia combined with proximal femoral shepherd deformity, pathological fracture of the femoral shaft complicated by bone Nonunion (Figure 3), multiple fracture lines can be seen on the right femur, old fracture lines and new fracture lines coexist, and the original fractures are malunion.
Preoperative imaging of the unaffected femur.
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F4
According to the length of the unaffected limb (Figure 4), a special length of intramedullary nail is ordered.
Intraoperative fluoroscopic imaging.
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F5
The length of intramedullary needles may take a long time and delay the operation date, resulting in complications such as thrombosis, fall off, and fracture pain of the lower extremities, increasing the risk of life and economic burden. The orthopedic bone block has a large resistance during the insertion of the intramedullary needle, so it is necessary to prevent stress fractures and implant fractures (Figure 5).
Postoperative external image.
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F6
After the operation, the deformity of the right thigh of the patient was relieved, but the knee valgus was still present (Figure 6).
Follow-up 3 months after surgery.
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F7
It was seen that the fracture end had a tendency to heal, and the patient was instructed to gradually bear weight (Figure 7); re-examination six months after the operation, the right femur was examined on the front and lateral sides, and the fracture was healed well.
6 months after the operation, the fracture line was further blurred.
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F8
Now the patient can walk with the aid of a walker (Figure 8); One year after the operation, the X-ray of the right femur was taken on the front and the lateral side (Figure 9): it was seen that the fractured end had healed.
At 14 months postoperatively, the fracture was completely healed.
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F9
Now the patient can walk with the aid of a walker (Figure 8); One year after the operation, the X-ray of the right femur was taken on the front and the lateral side (Figure 9): it was seen that the fractured end had healed.
One-year postoperative image.
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F10
Now the patient can walk without the aid of a walker and can take care of himself at home (Figure 10).