CONSERVATIVE VS. OPERATIVE MANAGEMENT OF LONG BONE FRACTURES IN OSTEOPETROSIS: LONG-TERM STUDY IN 12 YRS. PERIOD
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 69
Abstract
BACKGROUND Albers-Schonberg in 1907 described a rare developmental disease. [1] In 1926, Karshner introduced the term osteopetrosis. [2] Because of diminished bone resorption due to osteoclastic abnormality, bones become brittle and fractures easily. [3] Even though bone healing is delayed, most of the fractures are treated conservatively when operative intervention is needed; “it is a challenge to the orthopaedic surgeon.” The hardness of bone causes difficulty in penetration of drill bit and insertion of K-wires, screws, nails and bolts; and because of narrow medullary canal reaming is difficult. [4] In 12 yrs. period ten. METHODS AND MATERIALS 10 patients were treated by conservative and surgical methods. Age groups include 8 yrs. to 60 yrs. patients in which six were treated conservatively, four with operative intervention. One tibia fracture diagnosed non-union after 9 months, one femur fracture superficial infection noted. Sometimes faced difficulties in closed reduction in view of brittleness of bones. Because of more operative time, post-operative infection is common in operated cases. Breakage of drill bits is common. In this series, we discussed encountered problems and suggested some technical tips. [4] RESULTS 6 females, 4 males, bilateral 2 cases, 6 right side, 4 left side, 4 tibia, 5 femur and 1 pelvic fractures. All 10 cases united but one case of non-union noted and treated, the remaining 9 cases delayed union. CONCLUSION In our series most of long bone fractures are treated with non-operative methods and it works well. The surgical management is reasonable in certain circumstances such as non-union, implant failure, fracture shaft femur, coxa vara and failure of conservative treatment. Intraoperative complications include prolonged surgical time, breakage of drill bits and difficulty in insertion of nails and screws. Good preoperative planning and should anticipate forthcoming technical difficulties. Prior informed consent should be taken for prolonged intraoperative and postoperative course, risk of infection and iatrogenic fractures. In our series of 10 cases in 12 yrs. period all cases united, all the patients are doing well with few complications.
Authors and Affiliations
Ramkishan , Narsimulu
Keywords
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- EP ID EP154505
- DOI 10.14260/jemds/2016/1136
- Views 73
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