Skip to main content
Erschienen in: International Orthopaedics 6/2019

04.10.2018 | Original Paper

Fractures in patients with osteopetrosis, insights from a single institution

verfasst von: Anuj Chawla, Ernest Beng Kee Kwek

Erschienen in: International Orthopaedics | Ausgabe 6/2019

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Osteopetrosis is a hereditary skeletal disorder in which defective osteoclast function leads to abnormally hard and brittle bones. This study aims to describe the pattern of fractures occurring in this group of patients, possible complications, and strategies to avoid them.

Methods

This is a case series of six osteopetrotic patients with a total of 12 fractures managed in our institution over a period of nine years. Patient records were also reviewed for complications both intra- and post-operatively.

Results

The majority of the fractures involved the femur, with three of these being peri-implant in nature. Other bones involved include the tibia, humerus, patella, fifth metatarsal, and proximal phalanx of the toe. There was a high rate of complications while managing these patients: three patients had peri-implant stress fractures, three with retained broken screws, and one case each of delayed union, non-union, and surgical site infection.

Conclusion

Osteopetrosis fractures present a unique challenge to the orthopedic surgeon. Careful pre-operative planning should be undertaken before proceeding with surgery in these cases.
Literatur
1.
Zurück zum Zitat Shapiro F (1993) Osteopetrosis: current clinical considerations. Clin Orthop Relat Res 294:34–44CrossRef Shapiro F (1993) Osteopetrosis: current clinical considerations. Clin Orthop Relat Res 294:34–44CrossRef
3.
Zurück zum Zitat Bollerslev J, Andersen PE Jr (1989) Fracture patterns in two types of autosomal dominant osteopetrosis. Acta Orthop Scand 60:110–112CrossRefPubMed Bollerslev J, Andersen PE Jr (1989) Fracture patterns in two types of autosomal dominant osteopetrosis. Acta Orthop Scand 60:110–112CrossRefPubMed
4.
Zurück zum Zitat Salzano FM (1961) Osteopetrosis: review of dominant cases and frequency in a Brazilian state. Acta Genet Med Gemellol 10:353–358CrossRefPubMed Salzano FM (1961) Osteopetrosis: review of dominant cases and frequency in a Brazilian state. Acta Genet Med Gemellol 10:353–358CrossRefPubMed
5.
Zurück zum Zitat Benichou O, Cleiren E, Gram J, Bollerslev J, Vernejoul MCD, Hul WV (2001) Mapping of autosomal dominant osteopetrosis type II (Albers Schonberg disease) to chromosome 16p13.3. Am J Hum Genet 69:647–654CrossRefPubMedPubMedCentral Benichou O, Cleiren E, Gram J, Bollerslev J, Vernejoul MCD, Hul WV (2001) Mapping of autosomal dominant osteopetrosis type II (Albers Schonberg disease) to chromosome 16p13.3. Am J Hum Genet 69:647–654CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Armstrong DG, Newfield JT, Gillespie R (1999) Orthopedic management of osteopetrosis: results of a survey and review of the literature. J Pediatr Orthop 19:122–132PubMed Armstrong DG, Newfield JT, Gillespie R (1999) Orthopedic management of osteopetrosis: results of a survey and review of the literature. J Pediatr Orthop 19:122–132PubMed
7.
Zurück zum Zitat Teti A, Econs MJ (2017) Osteopetroses, emphasizing potential approaches to treatment. Bone 102:50–59CrossRef Teti A, Econs MJ (2017) Osteopetroses, emphasizing potential approaches to treatment. Bone 102:50–59CrossRef
8.
Zurück zum Zitat Bacon S, Crowley R (2018) Developments in rare bone diseases and mineral disorders. Ther Adv Chronic Dis 9(1):51–60CrossRefPubMed Bacon S, Crowley R (2018) Developments in rare bone diseases and mineral disorders. Ther Adv Chronic Dis 9(1):51–60CrossRefPubMed
9.
Zurück zum Zitat Milgram JW, Jasti M (1982) Osteopetrosis: a morphological study of 21 cases. J Bone Joint Surg Am 64:912–929CrossRefPubMed Milgram JW, Jasti M (1982) Osteopetrosis: a morphological study of 21 cases. J Bone Joint Surg Am 64:912–929CrossRefPubMed
10.
Zurück zum Zitat Jakub T, Steven LT, Paul JO (2004) Osteopetrosis review article. N Eng J Med 351:2839–2849CrossRef Jakub T, Steven LT, Paul JO (2004) Osteopetrosis review article. N Eng J Med 351:2839–2849CrossRef
11.
Zurück zum Zitat De Palma L, Tulli A, Maccauro G, Del Torto M (1994) Fracture callus in osteopetrosis. Clin Orthop Relat Res 308:85–89 De Palma L, Tulli A, Maccauro G, Del Torto M (1994) Fracture callus in osteopetrosis. Clin Orthop Relat Res 308:85–89
12.
Zurück zum Zitat Kunnasegaran R, Chan YH (2017) Use of an industrial tungsten carbide drill in the treatment of a complex fracture in a patient with severe osteopetrosis: a case report. Malays Orthop J 11(1):64–67CrossRefPubMedPubMedCentral Kunnasegaran R, Chan YH (2017) Use of an industrial tungsten carbide drill in the treatment of a complex fracture in a patient with severe osteopetrosis: a case report. Malays Orthop J 11(1):64–67CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Chawla A, Kwek EBK (2018) An unusual presentation of patella and fifth metatarsal base fractures in a patient with osteopetrosis. J Clin Orthop Trauma 9(2):S49–S51CrossRefPubMed Chawla A, Kwek EBK (2018) An unusual presentation of patella and fifth metatarsal base fractures in a patient with osteopetrosis. J Clin Orthop Trauma 9(2):S49–S51CrossRefPubMed
14.
Zurück zum Zitat Nakayama J, Fujioka H, Kurosaka M, Kitazawa H, Maesawa N, Tomioka M (2007) Surgery for clavicular and humeral fractures in an osteopetrosis patient: a case report. J Orthop Surg 15(2):251–254CrossRef Nakayama J, Fujioka H, Kurosaka M, Kitazawa H, Maesawa N, Tomioka M (2007) Surgery for clavicular and humeral fractures in an osteopetrosis patient: a case report. J Orthop Surg 15(2):251–254CrossRef
15.
Zurück zum Zitat Bhargava A, Vagela M, Lennox CME (2009) “Challenges in the management of fractures in osteopetrosis”! Review of literature and technical tips learned from long-term management of seven patients. Injury 40:1167–1171CrossRefPubMed Bhargava A, Vagela M, Lennox CME (2009) “Challenges in the management of fractures in osteopetrosis”! Review of literature and technical tips learned from long-term management of seven patients. Injury 40:1167–1171CrossRefPubMed
16.
Zurück zum Zitat Miguel AF, Carlos MO, Rodrigo FP, Sebastian S, Linda V (2015) Recommendations for fracture management in patients with osteopetrosis: case report. Arch Orthop Trauma Surg 135:351–356CrossRef Miguel AF, Carlos MO, Rodrigo FP, Sebastian S, Linda V (2015) Recommendations for fracture management in patients with osteopetrosis: case report. Arch Orthop Trauma Surg 135:351–356CrossRef
17.
Zurück zum Zitat Ahmadpour A, Goodarzi A, Lee DJ, Panchal RR, Kim KD (2018) Cervical spine fractures in osteopetrosis: a case report and review of the literature. J Biomed Res 32(1):68–76PubMedPubMedCentral Ahmadpour A, Goodarzi A, Lee DJ, Panchal RR, Kim KD (2018) Cervical spine fractures in osteopetrosis: a case report and review of the literature. J Biomed Res 32(1):68–76PubMedPubMedCentral
18.
Zurück zum Zitat Mohapatra B, Kishen T, Diwan AD (2010) Multiple lumbar pedicle fractures in osteopetrosis: a case report. Spine 35(8):311–315CrossRef Mohapatra B, Kishen T, Diwan AD (2010) Multiple lumbar pedicle fractures in osteopetrosis: a case report. Spine 35(8):311–315CrossRef
19.
Zurück zum Zitat Auerbach JD, McCormick FL, Mehta S, Brummett RS, Rushton SA (2007) Posterior cervical arthrodesis for subacute odontoid fracture in a patient with osteopetrosis case report. Spine 32(1):34–38CrossRef Auerbach JD, McCormick FL, Mehta S, Brummett RS, Rushton SA (2007) Posterior cervical arthrodesis for subacute odontoid fracture in a patient with osteopetrosis case report. Spine 32(1):34–38CrossRef
20.
Zurück zum Zitat Yamane K, Kai N (2018) Anterior cervical arthrodesis for chronic Hangman’s fracture in a patient with osteopetrosis: a case report. Arch Orthop Trauma Surg 138(6):783–789CrossRefPubMed Yamane K, Kai N (2018) Anterior cervical arthrodesis for chronic Hangman’s fracture in a patient with osteopetrosis: a case report. Arch Orthop Trauma Surg 138(6):783–789CrossRefPubMed
21.
Zurück zum Zitat Gupta R, Gupta N (2001) Femoral fractures in osteopetrosis: case reports. J Trauma 51:997–999CrossRefPubMed Gupta R, Gupta N (2001) Femoral fractures in osteopetrosis: case reports. J Trauma 51:997–999CrossRefPubMed
22.
Zurück zum Zitat Motoki S, Takatoshi O, Haruko O, Masaaki M, Takao H (2011) Bipolar hemiarthroplasty for subtrochanteric non-union in an adult with autosomal dominant osteopetrosis type II. J Orthop Sci 16:652–655CrossRef Motoki S, Takatoshi O, Haruko O, Masaaki M, Takao H (2011) Bipolar hemiarthroplasty for subtrochanteric non-union in an adult with autosomal dominant osteopetrosis type II. J Orthop Sci 16:652–655CrossRef
23.
Zurück zum Zitat Matsuno T, Katayama N (1997) Osteopetrosis and total hip arthroplasty. Int Orthop 21:409–411CrossRefPubMed Matsuno T, Katayama N (1997) Osteopetrosis and total hip arthroplasty. Int Orthop 21:409–411CrossRefPubMed
24.
Zurück zum Zitat Sen RK, Gopinathan NR, Kumar R, Saini UC (2013) Simple reproducible technique in treatment of osteopetrotic fractures. Musculoskelet Surg 97:117–121CrossRefPubMed Sen RK, Gopinathan NR, Kumar R, Saini UC (2013) Simple reproducible technique in treatment of osteopetrotic fractures. Musculoskelet Surg 97:117–121CrossRefPubMed
25.
Zurück zum Zitat Stalder H, Hochstetter AV, Schreiber A (1994) Valgus tibial osteotomy in a patient with benign dominant osteopetrosis (Albers-Schonberg disease). Int Orthop 18:304–307CrossRefPubMed Stalder H, Hochstetter AV, Schreiber A (1994) Valgus tibial osteotomy in a patient with benign dominant osteopetrosis (Albers-Schonberg disease). Int Orthop 18:304–307CrossRefPubMed
26.
Zurück zum Zitat Chhabra A, Westurlund LE, Kline AJ, McLaughlin R (2005) Management of proximal femoral shaft fractures in osteopetrosis: a case series using internal fixation. Orthopaedics 28(6):587–592 Chhabra A, Westurlund LE, Kline AJ, McLaughlin R (2005) Management of proximal femoral shaft fractures in osteopetrosis: a case series using internal fixation. Orthopaedics 28(6):587–592
27.
Zurück zum Zitat Mert K, Levent K, Mustafa I, Ahmet K (2013) Treatment of bilateral simultaneous subtrochanteric fractures with proximal femur nail antirotation (PFNA) in a patient with osteopetrosis: case report and review of the literature. J Orthop Sci 18:486–489CrossRef Mert K, Levent K, Mustafa I, Ahmet K (2013) Treatment of bilateral simultaneous subtrochanteric fractures with proximal femur nail antirotation (PFNA) in a patient with osteopetrosis: case report and review of the literature. J Orthop Sci 18:486–489CrossRef
28.
Zurück zum Zitat Joshua L, Nathaniel M, Paul DC (2007) Orthopaedic management of patients with osteopetrosis. J Am Acad Orthop Surg 15:654–662CrossRef Joshua L, Nathaniel M, Paul DC (2007) Orthopaedic management of patients with osteopetrosis. J Am Acad Orthop Surg 15:654–662CrossRef
29.
Zurück zum Zitat Sameh AS, Richard P, Shaw DL (2006) Reverse LISS plate stablisation of a subtrochanteric fracture of the femur in a patient with osteopetrosis: is this the answer? Injury Extra 37:113–115CrossRef Sameh AS, Richard P, Shaw DL (2006) Reverse LISS plate stablisation of a subtrochanteric fracture of the femur in a patient with osteopetrosis: is this the answer? Injury Extra 37:113–115CrossRef
30.
Zurück zum Zitat Srivastav A, Agarwal S, Mittal V, Srivastav S, Nadkarni B (2010) Fixation of subtrochanteric fractures in two patients with osteopetrosis using a distal femoral locking compression plate of the contralateral side. Eur J Trauma Emerg Surg 36:263–269CrossRef Srivastav A, Agarwal S, Mittal V, Srivastav S, Nadkarni B (2010) Fixation of subtrochanteric fractures in two patients with osteopetrosis using a distal femoral locking compression plate of the contralateral side. Eur J Trauma Emerg Surg 36:263–269CrossRef
31.
Zurück zum Zitat Bergmann G, Graicehn F, Rohlmann A (1993) Hip joint loading during walking and running, measured in two patients. J Biomech 26(8):969–990CrossRef Bergmann G, Graicehn F, Rohlmann A (1993) Hip joint loading during walking and running, measured in two patients. J Biomech 26(8):969–990CrossRef
Metadaten
Titel
Fractures in patients with osteopetrosis, insights from a single institution
verfasst von
Anuj Chawla
Ernest Beng Kee Kwek
Publikationsdatum
04.10.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Orthopaedics / Ausgabe 6/2019
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-018-4167-5

Weitere Artikel der Ausgabe 6/2019

International Orthopaedics 6/2019 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Notfall-TEP der Hüfte ist auch bei 90-Jährigen machbar

26.04.2024 Hüft-TEP Nachrichten

Ob bei einer Notfalloperation nach Schenkelhalsfraktur eine Hemiarthroplastik oder eine totale Endoprothese (TEP) eingebaut wird, sollte nicht allein vom Alter der Patientinnen und Patienten abhängen. Auch über 90-Jährige können von der TEP profitieren.

Arthroskopie kann Knieprothese nicht hinauszögern

25.04.2024 Gonarthrose Nachrichten

Ein arthroskopischer Eingriff bei Kniearthrose macht im Hinblick darauf, ob und wann ein Gelenkersatz fällig wird, offenbar keinen Unterschied.

Therapiestart mit Blutdrucksenkern erhöht Frakturrisiko

25.04.2024 Hypertonie Nachrichten

Beginnen ältere Männer im Pflegeheim eine Antihypertensiva-Therapie, dann ist die Frakturrate in den folgenden 30 Tagen mehr als verdoppelt. Besonders häufig stürzen Demenzkranke und Männer, die erstmals Blutdrucksenker nehmen. Dafür spricht eine Analyse unter US-Veteranen.

Ärztliche Empathie hilft gegen Rückenschmerzen

23.04.2024 Leitsymptom Rückenschmerzen Nachrichten

Personen mit chronischen Rückenschmerzen, die von einfühlsamen Ärzten und Ärztinnen betreut werden, berichten über weniger Beschwerden und eine bessere Lebensqualität.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.