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

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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.

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Fig. 1
Fig. 2

Abbreviations

ADO:

Autosomal dominant osteopetrosis

NSA:

Neck-shaft angle

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Authors and Affiliations

  1. Pediatric Orthopaedic Department, University Children’s Hospital Basel (UKBB), Römergasse 8, 4005, Basel, Switzerland

    Andreas H. Krieg & B. M. Speth

  2. Department of Orthopaedic Surgery, Women’s and Children’s Hospital, 72 King William Road, North Adelaide, SA , 5006, Australia

    H. Y. Won & P. D. Brook

Authors
  1. Andreas H. Krieg
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  2. B. M. Speth
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  3. H. Y. Won
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  4. P. D. Brook
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Correspondence to Andreas H. Krieg.

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Krieg, A.H., Speth, B.M., Won, H.Y. et al. Conservative management of bilateral femoral neck fractures in a child with autosomal dominant osteopetrosis. Arch Orthop Trauma Surg 127, 967–970 (2007). https://doi.org/10.1007/s00402-007-0392-x

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  • DOI: https://doi.org/10.1007/s00402-007-0392-x

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