Pelvic Ring and Peritrochanteric Fractures in a Patient with Osteogenesis Imperfecta Treated Surgically: Case Report with a 5-Year Follow-Up

Abstract

Patient: Male, 52-year-old Final Diagnosis: Osteogenesis imperfecta • pelvic ring fracture • peritrochanteric fracture Symptoms: Limited mobility • pain Medication: — Clinical Procedure: — Specialty: Surgery Objective: Congenital defects/diseases Background: Osteogensis imperfecta (OI) is a rare disorder associated with brittle bones, skeletal deformities, short stature, and conductive hearing loss. It is caused by mutations in genes encoding collagen type I production and is associated with multiple fractures occurring during a patient’s lifetime. Atypical fractures can occur without a history of previous injury or diagnosis. Case Report: A 52-year old man sustained a fall from his own height. He experienced pelvic pain but could bear weight. He was referred to the hospital by his primary care physician and was admitted to the Orthopedic Department with a pelvic ring fracture. We performed open reduction and internal fixation with a reconstruction plate via an intrapelvic approach. At 12 weeks after discharge, he sustained a peritrochanteric fracture. It was surgically treated with a dynamic hip screw. The patient commenced weight-bearing 20 weeks after the initial procedure. Bone union was achieved clinically and radiographically. He did not have any revision procedures. At the time of this report, 5 years after the described period, he felt no discomfort around the hips, sacroiliac joints, and pubic symphysis. Conclusions: OI poses a difficult treatment challenge, but, achieving a good clinical and functional result is possible with a precise surgical technique and meticulous preoperative planning. Clinicians should always consider the possibility of a simultaneous fracture occurrence in different parts of the body. Some patients present without a previous diagnosis, and we should always have some suspicion of OI in cases of young patients presenting with low-energy fractures.

Acetabular fracture and central hip dislocation in osteogenesis imperfecta child treated surgically with bone grafts augmented by recombinant human bone morphogenetic protein-2: A rare case report

“…Thus, the procedure will take longer surgical time, more blood loss, and complications such as avascular necrosis of the femoral head, osteoarthritis, and HO [ 10 , 11 ]. Fractures in OI patients typically occur in young patients who have been traumatized with low energy [ 12 ]. Despite recent locking plates, there is still a higher risk of malunion and non-union, poor callus quality, and fixation destabilization because of low bony support [ 13 ].…”

“…Precise surgical technique combined with a meticulous preoperative plan can achieve a satisfactory clinical and functional result [ 15 ]. A 5-year follow-up reported by Zawadski et al on a geriatric OI type I patient treated with ORIF and a reconstruction plate for pelvic ring fracture showed superior clinical and radiographic results [ 12 ]. Meanwhile, Medici et al published a case of bilateral acetabular fracture with protrusio acetabulum in an OI type I patient treated in 2 stages.…”