Fracture Treatment in Intermediate Autosomal Recessive Osteopetrosis

Ryšavý, Martin; Arun, K; Wozniak, Aniela

doi:10.3928/01477447-20070701-07

Cited by 4 publications

(3 citation statements)

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“…Several EM implants, such as dynamic hip screw (DHS), proximal femoral locking compression plate (PF‐LCP), and DF‐LCP, were reported to be used in treating OSF. For the use of DHS, Rysavy 23 described the prolonged operation time, which was up to 4 hours, and Kumar 22 emphasized the difficulty in the creation of the screw canal towards femoral head. Dawar et al 24 .…”

Section: Discussionmentioning

confidence: 99%

“… 11 reviewed the available literature and reported a non‐union rate of 12%, infection rate of 12%, and hardware failure rate of 29% on the surgical treatment of osteopetrotic fractures in adults. According to our literature review on osteopetrotic fracture around femoral trochanter 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 31 , 36 , 37 , 38 , 39 , 40 , 41 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , the non‐union rate of the surgical treatment was about 15.28% (11/72), infection rate was about 9.72% (7/72), hardware failure rate was about 11.11% (8/72), and periprosthetic fracture incidence was about 8.33% (6/72). It is a serious challenge for orthopaedic surgeons to choose the appropriate implants and surgical procedures for osteopetrotic fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Surgical management is recommended in situation involving femoral head/shaft fracture, coxa vara, and failure of conservative treatment 12 , 13 . A few studies introduced the application of intramedullary (IM) nail 14 , 15 , 16 , 17 , 18 , dynamic condylar screw (DCS) 19 , 20 , dynamic hip screw (DHS) 21 , 22 , 23 , proximal femoral locking compression plate (PF‐LCP) 24 , 25 , and reversed contralateral distal femoral locking compression plate (DF‐LCP) 26 , 27 , 28 in osteopetrotic subtrochanteric fracture (OSF) and the rate of complication was high. The most optimal implant and a proper surgical intervention remain controversial.…”

Section: Introductionmentioning

confidence: 99%

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The Treatment of Subtrochanteric Fracture with Reversed Contralateral Distal Femoral Locking Compression Plate (DF‐LCP) Using a Progressive and Intermittent Drilling Procedure in Three Osteopetrosis Patients

Liu

Jia

et al. 2021

Orthopaedic Surgery

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Objective To describe the application of reversed contralateral distal femoral locking compression plate (DF‐LCP) inserted through a progressive and intermittent drilling procedure in the treatment of osteopetrotic subtrochanteric fracture (OSF). Methods Three patients (one male and two females with an average age of 45.33 ± 11.09 years) with OSF hospitalized between September 2015 and September 2020, were included in this present study. Lateral approach was applied in all patients who accepted open reduction and internal fixation (ORIF) with a reversed contralateral DF‐LCP inserted through a progressive and intermittent drilling procedure. The operation time and intraoperative blood loss were recorded to evaluate the efficiency of this surgical method. Physical examination and imaging examination of the fracture site were used to evaluate the fracture union status, the position and stability of the implant, and the alignment of the injured limb at 1, 3, 6, and 12 months after operation, then a subsequent visit was conducted at least once a year. Harris Hip Score (HHS) was used to evaluate the hip joint function at 6 and 12 months after operation. Results The average operation time was 140 ± 21.60 min (110, 160, and 150 min); The average intraoperative blood loss was about 333.33 ± 23.57 ml (300, 350, and 350 ml). The average follow‐up time was 22.33 ± 7.41 months (29, 26, and 12 months). All patients achieved bone union with an average time of 6.67 ± 0.94 months (6, 8, and 6 months). At the time of 6 months after operation, case 1 and 3 were almost pain‐free and could walk with full weight bearing while case 2 could walk only with partial weight bearing using a crutch. The HHS scores of cases 1, 2, and 3 were 84/100, 74/100, and 92/100, respectively. At the follow‐up at 12 months after operation, the HHS score improved to 91/100, 81/100, and 96/100, respectively. The contralateral incomplete old subtrochanteric fracture was deteriorated in case 1 at 26 months after operation. After 3 months of limited weight bearing using a crutch, bone union was verified in radiograph imaging. Fresh contralateral subtrochanteric fracture occurred in case 2 at 26 months after operation, which was treated using a similar surgical approach, and its clinical outcome is under follow‐up. Moreover, no perioperative complications including operation‐related death, vascular/nerve injury, deep venous thrombosis, pulmonary embolism, and incision infection, and long‐term complications involving malunion, nonunion, implant failure, ankylosis, heterotopic ossification, osteonecrosis, and osteomyelitis were identified. Conclusion The application of reversed contralateral DF‐LCP in OSF is practicable and reliable. Progressive and intermittent drilling is a safe and efficient method for implant insertion in this complicated situation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Treatment of Subtrochanteric Fracture with Reversed Contralateral Distal Femoral Locking Compression Plate (DF‐LCP) Using a Progressive and Intermittent Drilling Procedure in Three Osteopetrosis Patients

Liu

Jia

et al. 2021

Orthopaedic Surgery

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Report of two Chinese patients suffering from CLCN7-related osteopetrosis and root dysplasia

Xue

Wang

Mao

et al. 2012

Journal of Cranio-Maxillofacial Surgery

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Surgical Treatment of Osteopetrosis-Related Femoral Fractures: Two Case Reports and Literature Review

Aslan¹,

Baykal

Uysal

et al. 2014

Case Reports in Orthopedics

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Osteopetrosis is a rare hereditary disease which is characterized by increased bone density. Bone resorption is insufficient or fails due to the osteoclast defect in osteopetrosis. Half of the patients are asymptomatic and diagnosed incidentally or based on the presence of fracture. Adult onset osteopetrosis usually presents with hip and proximal femoral fractures. Internal fixation can be performed; however, technical challenges may be experienced due to increased bone density. As in other fractures, nonunion or varus malunion of these fractures may occur. Although rare, osteopetrosis may complicate treatment of fractures in such patients. In this study, we aimed to present two new cases of ADO type II with an osteopetrotic femoral fracture along with the clinical and radiological findings in the light of a comprehensive literature review. Orthopaedics surgeons should be aware of intraoperative technical difficulties and possible postoperative complications during the follow-up period. Investigation would be beneficial for the diagnosis of osteopetrosis such the patient with fractures who has minor trauma history and increased bone density in radiography.

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Fracture Treatment in Intermediate Autosomal Recessive Osteopetrosis

Cited by 4 publications

References 0 publications

The Treatment of Subtrochanteric Fracture with Reversed Contralateral Distal Femoral Locking Compression Plate (DF‐LCP) Using a Progressive and Intermittent Drilling Procedure in Three Osteopetrosis Patients

The Treatment of Subtrochanteric Fracture with Reversed Contralateral Distal Femoral Locking Compression Plate (DF‐LCP) Using a Progressive and Intermittent Drilling Procedure in Three Osteopetrosis Patients

Report of two Chinese patients suffering from CLCN7-related osteopetrosis and root dysplasia

Surgical Treatment of Osteopetrosis-Related Femoral Fractures: Two Case Reports and Literature Review

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