We have a patient 27 y.o. with malunion of femoral fracture (deformity of 32 degree varus, middle third). He presents autosomic dominant osteopetrosis.
Dear Dmitry
According to some treated patients with osteopetrosis and pycnodisitosis, the main risk is the non union
The second problem is do the osteotomy: it is very difficult due the the sclerotic bone
The third thing is the very narrow intramedullary canal
I'm sure you know that!
For these reasons, you may be very safe before to do this correction. You may be could use a rigid intramedullary nail or big K wires for getting the stabilty and axis
Therefore, all the surgical risks must be considered
With my personal best regards
Pierre Journeau
Cher Pierre!
Je te remercie pour la reponse. We are going to try 2 to 3 K-wires.to avoid secondary rotation of the fragments. Do you know some literature about deformity correction in osteopetrosis?
Bien amicalement,
Dimitri
Dear Dmitry,
Unfortunately, our group has no experience with long bone deformity correction in patients with osteopetrosis.
I found two articles that evaluated patients with osteopetrosis , but certainly you 've read. Likewise I sending the title
1. Orthopedic Management of Osteopetrosis: Results of a Survey and Review of the Literature
2. Type II autosomal dominant osteopetrosis (Albers-Schönberg disease): clinical and radiological manifestations in 42 patients
I hope I was helpfull,
Best regards,
Camila
Dear Dimitri,
Almost no experience with deformity correction of long bones in adult patients with osteopetrosis. I found two articles which might be helpfull in decision making of treatment in this rare disease.
Case Reports: Treatment of Subtrochanteric and Ipsilateral Femoral Neck Fractures in an Adult with Osteopetrosis
Surgical Treatment of Osteopetrosis-Related Femoral Fractures: Two Case Reports and Literature Review
Kind regards,
Nenad Atanasov
Dears colleagues!
Thank for your attention to my question and provided information
Dear colleaugues!
Dear Dmitry this is very interesting topic, and I agree with Prof Journeau for the risk of non union, osteotomy problem and narrow intramedullary canal because of abnormal bone turnover. Sclerosis also hinders bone fixation.
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