Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania.
Geisinger Medical Center, Danville, Pennsylvania.
JBJS Case Connect. 2020 Oct 20;10(4):e20.00369. doi: 10.2106/JBJS.CC.20.00369.
A 1-week-old female patient presented to our clinic with bilateral dislocated hips and was subsequently treated in a Pavlik harness. Harness treatment failed requiring a closed reduction and spica cast application. In the Post-Anesthesia Care Unit (PACU), the patient was found to have a right humerus fracture. Six weeks after cast application, the patient was found to have nondisplaced bilateral femur fractures prompting a genetics evaluation. The patient was subsequently found to have osteogenesis imperfecta type 3.
Perioperative fractures in pediatric patients should raise suspicion for osteogenesis imperfecta. Early diagnosis can improve the management of hip dysplasia and allow for early bisphosphonate therapy.
一名 1 周龄女性患者双侧髋关节脱位，随后使用帕夫利克吊带进行治疗。吊带治疗失败，需要进行闭合复位和石膏管型固定。在麻醉后护理单元（PACU），发现患者右侧肱骨骨折。石膏固定 6 周后，发现双侧股骨骨折无移位，提示进行基因评估。随后发现患者患有 3 型成骨不全症。
小儿患者围手术期骨折应怀疑成骨不全症。早期诊断可以改善髋关节发育不良的管理，并允许早期使用双膦酸盐治疗。
