Femoral neck fractures in osteogenesis imperfecta patients: A retrospective case series and novel surgical technique

Gorsche, Mark T.; Caird, Michelle S.; Farley, Frances A.; Li, Ying; Abbott, Matthew D.

doi:10.5430/css.v3n3p14

Cited by 1 publication

(5 citation statements)

References 11 publications

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“…Compared with previous reports [3][4][5][6][7]9], we included the angulated-stable type of FNF and used diverse surgical methods according to the fracture pattern and patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…We analyzed 15 cases of FNF in 10 osteogenesis imperfecta patients, categorized them into three patterns, and reported the treatment methods and their outcomes. Compared with previous reports [3–7,9], we included the angulated-stable type of FNF and used diverse surgical methods according to the fracture pattern and patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…As reported by several studies [1,4,5,7], the screw fixation of FNF in the femur harboring IM rod is technically demanding. Managing an osteogenesis imperfecta patient on a fracture table is practically impossible or associated with an increased risk of secondary fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Femur is the third most frequent bone associated with fractures in osteogenesis imperfecta patients, and mid-shaft is the most common site involved [2]. Femoral neck fracture (FNF), however, is relatively rare, with only a few reports involving osteogenesis imperfecta patients [3][4][5][6][7][8]. Previous reports included small series treated with one to two methods of fixation [3,[5][6][7][8], a single case report [4] or a single case in a series [9].…”

Section: Introductionmentioning

confidence: 99%

“…Femoral neck fracture (FNF), however, is relatively rare, with only a few reports involving osteogenesis imperfecta patients [3][4][5][6][7][8]. Previous reports included small series treated with one to two methods of fixation [3,[5][6][7][8], a single case report [4] or a single case in a series [9]. Surgeons usually face difficulties when operating FNFs in osteogenesis imperfecta patients because of the small skeletal size, poor bone quality, suboptimal intraoperative imaging due to deformity of the proximal femur and pelvis and preexisting implants such as telescopic intramedullary (IM) rod [1,3].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Patterns of femoral neck fracture and its treatment methods in patients with osteogenesis imperfecta

Hong

Lee

Chung

et al. 2021

Journal of Pediatric Orthopaedics B

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Femoral neck fracture (FNF) is not common in osteogenesis imperfecta patients but may result in serious complications if not properly treated in due time. We present three types of FNF in osteogenesis imperfecta and their characteristics, treatment methods and outcomes. Cases of FNF followed for more than 2 years were selected from the osteogenesis imperfecta database. Medical records and radiographs were reviewed to obtain demographic information and to determine ambulatory status, mode of injury, location of the fracture line, presence of preexisting implants, treatment methods and complications. Outcomes were evaluated according to the radiographic results and ambulatory function. The study investigated 15 FNFs in 10 patients including 1 Sillence type I, 1 type III and 8 type IV. They were either community or household ambulators. The mean age at fracture was 11.7 years. The fractures were followed for an average of 6.3 years. Six fractures were attributed to accidental injuries and nine without noticeable trauma. The fracture pattern was categorized into undisplaced (n = 3), angulated-stable (n = 7) or displaced-unstable (n = 5) types. Five fractures were fixed in-situ using screws or Kirschner wires. Other five fractures were treated by closed reduction and screw fixation and the remaining five fractures were managed by femoral valgus osteotomy. Bony union was achieved, and prefracture ambulatory status was restored in all cases. A high index of suspicion is required in the diagnosis of undisplaced or angulatedstable fractures. Treatment is usually challenging, but a judicious approach considering the fracture pattern and patient characteristics result in successful outcomes. The angulated-stable pattern of fracture is unique in osteogenesis imperfecta patients and requires special attention.

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