Fracture patterns in thalassemia.

Of 61 patients with homozygous beta-thalassemia, 30 had fractures; the majority were single fractures. In three thalassemic families, multiple fractures were observed. Although fractures occurred mostly during the growth period, no epiphyseal fractures were found among the patients in the present study. Roentgenograms showed either horizontal or oblique fractures, frequently with compression, or linear fractures without displacement. No delay in fracture healing or residual gross bone deformities were noted, with the exception of fractures of the femoral neck. On the basis of clinical and scintigraphic examinations, four additional adolescent patients, excluded from this study, were suspected of having microfractures around their ankles and knees. In the future, with improvements in diagnostic methods, microfractures may be found often and recognized as a common source of acute pain about the knees and ankles of thalassemic patients.