Conservative management of bilateral femoral neck fractures in a child with autosomal dominant osteopetrosis

Arch Orthop Trauma Surg. 2007 Dec;127(10):967-70. doi: 10.1007/s00402-007-0392-x. Epub 2007 Jul 17.

Abstract

Management of minimally displaced femoral neck fractures in paediatric patients with autosomal dominant osteopetrosis (ADO) remains unclear as only small numbers have been reported. There are no detailed reports on successful conservative treatment. Common causes of failure in this particular area include non-union and development of coxa vara. Although there are no quantitative studies, case reports have influenced most authors to recommend operative treatment. It is well recognised that operative treatment of osteopetrotic bone is challenging. Problems arise intraoperatively due to the bone hardness, and postoperatively due to altered biomechanics and defective remodelling. This case of a child with ADO who suffered two asynchronous compression-side stress fractures in the femoral neck demonstrates that non-operative management can be satisfactory. After 8 weeks with partial weight-bearing the fractures were stable. At the latest follow-up 2.5 and 4 years after the fractures the patient presented with an excellent clinical and radiological outcome. There was no development of coxa vara.

Publication types

  • Case Reports

MeSH terms

  • Child
  • Crutches
  • Femoral Neck Fractures / diagnostic imaging
  • Femoral Neck Fractures / etiology
  • Femoral Neck Fractures / therapy*
  • Fracture Healing
  • Fractures, Compression / diagnostic imaging
  • Fractures, Compression / etiology
  • Fractures, Compression / therapy*
  • Fractures, Stress / diagnostic imaging
  • Fractures, Stress / etiology
  • Fractures, Stress / therapy*
  • Humans
  • Male
  • Osteopetrosis / complications*
  • Radiography
  • Weight-Bearing