Orthopaedic Management of the Patient With Osteopetrosis

Landa, Joshua; Margolis, Nathaniel; Cesare, Paul Di

doi:10.5435/00124635-200711000-00004

Cited by 65 publications

(62 citation statements)

References 36 publications

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“…Although all such precautions can leads to prolonged operating time and increases the anesthetic risks to the patients. 10 The various operative treatment methods for treatment of subtrochanteric fractures in osteopetrotic patients have been described in literature with different outcomes. The authors have used nail plate devises, DHS, distal femoral locking plates, nails (zickel, jewett, kuntscher, proximally locked), total hip arthoplasty and external fixator for fixation of such fractures.…”

Section: Discussionmentioning

confidence: 99%

“…5,11e14 Some authors preferred nails (load sharing implant) over plates and screw devises (load bearing) for treatment of long bone fractures of osteopetrotic bone as screw holes and plate ends create areas of increased stress and are prone to failure because of the increased demand placed on them during union. 10 An alternative for reducing the stress in plate fixation is the use of a locking plate.…”

Section: Discussionmentioning

confidence: 99%

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Metachronous bilateral subtrochanteric fracture of femur in an osteopetrotic bone: A case report with technical note

Kumar

Jain

Lal

et al. 2012

Journal of Clinical Orthopaedics and Trauma

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BilateralSubtrochanteric Femur a b s t r a c t Osteopetrosis is a rare inherited skeletal disorder characterized by increased density. The increased fragility of such dense bone results in a greater incidence of fractures, especially around hip and proximal femur. The surgical treatment of such fractures is difficult due to hard but brittle structure of bone. Herein we report a case of bilateral subtrochanteric fracture in an osteopetrotic patient. It was fixed using a dynamic hip screw with plate.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Metachronous bilateral subtrochanteric fracture of femur in an osteopetrotic bone: A case report with technical note

Kumar

Jain

Lal

et al. 2012

Journal of Clinical Orthopaedics and Trauma

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“…Because the bone of patients with osteopetrosis is hard and brittle, it is very difficult for surgeons to drill the bone or fix a plate along the bone. It should be noted that too much strength may cause a new fracture (Chhabra et al 2005;Landa et al 2007). The surgeon will face two challenges in the treatment of osteopetrosis patients with recurrent fractures; the first is how to remove the implanted steel and the second is how to install a new plate onto the bone (Ramiah et al 2006).…”

Section: Discussionmentioning

confidence: 99%

“…The internal fixation is difficult to preform in part due to bone fragility; therefore, orthopedists may prefer to conservative treatment with skeletal traction or plaster fixation. Up to now, there have been only limited reports that compared the effectiveness of the treatment for fractured patients with osteopetrosis between conservative and operation treatments (Landa et al 2007;Rafiq et al 2009). However, these reports should be evaluated with caution, because patients from these reports have the different genetic background and life style, each of which may influence the treatment effect.…”

Section: Introductionmentioning

confidence: 99%

Surgical Treatment of an Osteopetrotic Patient with Postoperative Fractures: Lessons from Siblings with Osteopetrosis

Huang

Liang

Qian

et al. 2013

Tohoku J. Exp. Med.

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Osteopetrosis is a rare, inherited disease characterized by dense and brittle bones, and it is associated with an increased risk of femoral fractures. However, the surgical treatment of the fracture patients with osteopetrosis is a subject of controversy, because it is difficult to compare the treatment effects between surgical treatment and conservative treatment in part due to the rarity of siblings with osteopetrosis. In fact, the genetic background and the environmental factors, such as living conditions and daily work, may influence the prognosis of the fracture patients with osteopetrosis. Here we describe siblings with osteopetrosis, a 23-year-old female patient and her older brother, both of whom had suffered from bilateral femoral fractures at their childhood. They do not have other brothers or sisters, and their parents are healthy. The younger sister had undergone surgical treatment for femoral fractures at the age of 8 years and recovered very well. In contrast, her brother had received the conservative treatment for femoral fractures at the age of 6 years, and thereafter he is badly disabled due to the malunion of the fractured femurs. Apparently, the surgical treatment is superior to the conservative treatment for the fracture patient with osteopetrosis. Unfortunately, fifteen years later, the sister fractured again at both femurs and underwent another operation. She recovered quickly from the second operation, indicating that second operation should be considered in osteopetrosis patients with postoperative fractures. The present report provides valuable information for the choice of treatment of femoral fractures associated with osteopetrosis.

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“…It typically presents with pathologic fractures that can occur at any age. Although most patients are diagnosed after their first fractures, 40% of patients will remain asymptomatic [61].…”

Section: The Effect Of Disorders In Bone Remodeling On Bone Qualitymentioning

confidence: 99%

Diseases Affecting Bone Quality: Beyond Osteoporosis

Unnanuntana

Rebolledo

Khair

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Bone quantity, quality, and turnover contribute to whole bone strength. Although bone mineral density, or bone quantity, is associated with increased fracture risk, less is known about bone quality. Various conditions, including disorders of mineral homeostasis, disorders in bone remodeling, collagen disorders, and drugs, affect bone quality. Questions/purposes The objectives of this review are to (1) identify the conditions and diseases that could adversely affect bone quality besides osteoporosis, and (2) evaluate how these conditions influence bone quality. Methods We searched PubMed using the keywords ''causes'' combined with ''secondary osteoporosis'' or ''fragility fracture.'' After identifying 20 disorders/conditions, we subsequently searched each condition to evaluate its effect on bone quality. Results Many disorders or conditions have an effect on bone metabolism, leading to fragility fractures. These disorders include abnormalities that disrupt mineral homeostasis, lead to an alteration of the mineralization process, and ultimately reduce bone strength. The balance between bone formation and resorption is also essential to prevent microdamage accumulation and maintain proper material and structural integrity of the bone. As a result, diseases that alter the bone turnover process lead to a reduction of bone strength. Because Type I collagen is the most abundant protein found in bone, defects in Type I collagen can result in alterations of material property, ultimately leading to fragility fractures. Additionally, some medications can adversely affect bone. Conclusions Recognizing these conditions and diseases and understanding their etiology and pathogenesis is crucial for patient care and maintaining overall bone health.

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Orthopaedic Management of the Patient With Osteopetrosis

Cited by 65 publications

References 36 publications

Metachronous bilateral subtrochanteric fracture of femur in an osteopetrotic bone: A case report with technical note

Metachronous bilateral subtrochanteric fracture of femur in an osteopetrotic bone: A case report with technical note

Surgical Treatment of an Osteopetrotic Patient with Postoperative Fractures: Lessons from Siblings with Osteopetrosis

Diseases Affecting Bone Quality: Beyond Osteoporosis

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