Panzica Martin, Garapati Rajeev, Zelle Boris, Krettek Christian, Tscherne Harald, Pape Hans-Christoph
Department of Trauma Surgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
Arch Orthop Trauma Surg. 2004 Jun;124(5):341-5. doi: 10.1007/s00402-004-0644-y. Epub 2004 Mar 18.
The main feature of osteogenesis imperfecta is an excessive fragility and deformability of the bones owing to reduced mass and bone quality. This leads to angular deformity and frequent fractures. These fractures usually heal rapidly, and conservative treatment is the norm. In displaced and unstable fractures, elastic intramedullary nailing is a treatment option. We report a case of a 3-year-old child with osteogenesis imperfecta type I who suffered an undisplaced femoral shaft fracture in the presence of a preexisting 32 degrees femoral antecurvation. This deformity greatly increases the risk of a refracture due to the pathological induction of stress risers. Therefore, fracture treatment by unreamed elastic intramedullary nailing was combined with simultaneous correction osteotomy, resulting in anatomic alignment and uncomplicated fracture healing. The single-stage surgical stabilization performed allowed rapid mobilization along with a decreased likelihood of refracture.
成骨不全的主要特征是由于骨量和骨质减少导致骨骼过度脆弱和易变形。这会导致角状畸形和频繁骨折。这些骨折通常愈合迅速,保守治疗是常规方法。对于移位和不稳定骨折,弹性髓内钉固定是一种治疗选择。我们报告一例3岁I型成骨不全患儿,其在已有32度股骨前弯的情况下发生了无移位股骨干骨折。这种畸形由于应力集中器的病理诱导而大大增加了再骨折的风险。因此,采用未扩髓弹性髓内钉固定治疗骨折并同时进行矫正截骨术,实现了解剖复位和骨折顺利愈合。实施的单阶段手术稳定化使得能够快速活动,同时降低了再骨折的可能性。