Simple reproducible technique in treatment for osteopetrotic fractures

Sen, Ramesh Kumar; Gopinathan, Nirmal Raj; Kumar, Rajesh; Saini, Uttam Chand

doi:10.1007/s12306-012-0222-3

Cited by 22 publications

(17 citation statements)

References 10 publications

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“…Out of these 5 patients there were 4 males and 1 female with a M:F ratio of 1:0.25. This was similar to male preponderance seen in our study [15] . The most common age group affected was found to be 31-35 years followed by in our study followed by 26-30 years.…”

Section: Discussionsupporting

confidence: 92%

Management of femoral fractures in adult onset osteopetrosis: A multicentric retrospective study

Rahate¹,

Tarlekar²,

Jiwani³

et al. 2018

Int. J. Orthop. Sci.

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Background: Osteopetrosis is a relatively rare disease with an incidence of approximately 1 case per 2,00,000 to 5,00,000 population. The clinical features of osteopetrosis includes pathological fractures, severe anemia due to defective erythropoiesis, bone marrow failure, coagulation defects, propensity for developing severe infections. Common fractures seen in these patients include hip and femoral fractures. Management of fractures in these patients is technically difficult and postoperative complications are common. We conducted a retrospective study of 20 patients with osteopetrosis who presented with femoral fractures and were treated in our institute. Materials and Methods:This was a multicentric retrospective study of 20 patients with osteopetrosis who presented with femoral fractures. The patients were included in this study on the basis of predefined inclusion and exclusion criteria. The diagnosis was based upon imaging studies (X-Rays in all the patients and CT in selected cases). The operative procedure post-operative complications, functional outcome and complications during follow up were studied from case papers. The data was tabulated and analyzed using Minitab 17 version software. Results: Out of 20 studied cases there were 16 (80%) males and 4 (20%) females with a M:F ratio of 1: 0.25. The most common affected age group was found to be between 30 -35 years (35%). Majority of patient sustained fracture following motor vehicular accidents (65%) followed by fall from height (20%) and direct blow or assault (15%). 13 patients were found to be having co-morbidities including anemia, carpal tunnel syndrome and visual disturbances. Open reduction and internal fixation was done in all the cases. Technical difficulties seen during operative procedures included difficult because of obliterated canal, sclerosed medulla and dense swarf. Common complications in these patients included wound infection, hematoma formation and arthritis of hip joint (5%). Repeat surgeries were required in 3 (15%) patients and 1 (5%) patient developed non-union of the fracture ends. Conclusion: Management of femoral fracture in patients with osteopetrosis is challenging for operating orthopedic surgeon. Common problems encountered during open reduction and internal fixation include overheating during drilling, smoke production and increased temperature of both bone and drill bits and production of dense bone swarf. Orthopedic surgeon should be aware of these technical difficulties encountered during operative interventions.

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Section: Discussionsupporting

confidence: 92%

Management of femoral fractures in adult onset osteopetrosis: A multicentric retrospective study

Rahate¹,

Tarlekar²,

Jiwani³

et al. 2018

Int. J. Orthop. Sci.

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“…Sen et al recommended using a metal-cutting drill bit to overcome the problem of drill bit breakage. Thus, the drilling was easier and thermal necrosis was prevented 7. Both these studies stated that extra care must be shown to prevent the breakage of drill bits 6,7…”

Section: Discussionmentioning

confidence: 99%

Proximal femoral fracture surgery in a patient with osteopetrosis tarda: complications and treatment strategy

Seyfettinoğlu

Tuhanioğlu

Oğur

et al. 2016

IMCRJ

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Osteopetrosis is a rare, inherited disease characterized by defects in osteoclastic function that results in defective bone resorption. When fractures are encountered, fixation is extremely difficult. Osteopetrosis patients have an increased predisposition to infection. If infection develops after a fracture, treatment is more difficult. In this paper, treatment is presented of a 49-year old female to whom proximal femoral nailing was applied for fixation of an osteopetrotic proximal femur fracture; and when it was unsuccessful, revision was made with a locked anatomic plate, which subsequently led to development of infection.

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“…Although some authors reported excellent outcomes of the plate-screw system, revision surgery due to implant failure was required in several cases [6, 11, 20–28]. There was also an attempt to prevent implant failure through an augmented technique of osteosynthesis with the plate-screw system [7, 25]. Kulkarni et al [21] reported a 22-year-old male case of ADO type II with the left femoral shaft fracture and a 47-year-old male case of ADO type II with the right subtrochanteric fracture.…”

Section: Discussionmentioning

confidence: 99%

“…Technical difficulties include bending of drill bits or screws during surgery using drilling or carving due to hard-fragile sclerotic bones and a narrow medullary canal. Slow-speed high-torque electric drills, as well as frequent cooling with physiological saline, clearance of drill grooves, and the use of staggered drill system, have been recommended [12, 17, 25]. However, there is still an increased risk of implant failure and nonunion for internal fixation [12, 17].…”

Section: Discussionmentioning

confidence: 99%

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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Simple reproducible technique in treatment for osteopetrotic fractures

Cited by 22 publications

References 10 publications

Management of femoral fractures in adult onset osteopetrosis: A multicentric retrospective study

Management of femoral fractures in adult onset osteopetrosis: A multicentric retrospective study

Proximal femoral fracture surgery in a patient with osteopetrosis tarda: complications and treatment strategy

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

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