Augmentation of simultaneous acetabular and femoral neck fracture in osteogenesis imperfecta using photodynamic bone stabilization - A case report.
Bone augmentation
Fracture treatment
Illuminoss®
Osteogenesis imperfecta
Photodynamic bone stabilization system
Journal
Trauma case reports
ISSN: 2352-6440
Titre abrégé: Trauma Case Rep
Pays: Netherlands
ID NLM: 101711730
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
accepted:
21
04
2019
entrez:
25
12
2019
pubmed:
25
12
2019
medline:
25
12
2019
Statut:
epublish
Résumé
Surgical fracture treatment in patients suffering from "osteogenesis imperfecta" (OI) is challenging and often results in unsatisfactory fixation of implants due to altered bone quality. Even the use of locking plates bears a residual risk to develop a loss of reduction leading to secondary fracture dislocation. However, the augmentation with an intramedullary photodynamic bone stabilization system (PBS) (e.g. Illuminoss®) may increase bone stability and allow for a sufficient anchorage of established implants even in OI patients. We report the case of a 41-year-old male patient with the diagnosis of OI. He sustained a medial femoral neck fracture (Garden type IV, Pauwels type III) and a fracture of the acetabulum (AO-Type 62-B.3) - both right-sided - after a blunt trauma during a bicycle accident. The medial femoral neck fracture was subsequently surgically treated to preserve the femoral head. After augmentation of the proximal femur with the PBS, a Dynamic Hip Screw (DHS) was implanted. After a short recovery, the acetabular fracture was surgically treated by intramedullary augmentation and locking plate fixation.The patient was discharged seven days after the surgical intervention of the acetabular fracture. Partial weight-bearing activities of the right lower extremity were performed on crutches for 6 weeks. The patient was able to do his outpatient rehabilitation program without any complications. He returned to work eight weeks after surgery. After a follow-up of four months, the patient presented full weight-bearing without assistance. No physical complaints were reported 14 months after surgery (Harris Hip Score 90). To the best of our knowledge, we report the augmentation with a photodynamic bone stabilization system of internal fixation techniques in an OI patient with fractures of the femoral neck and the acetabulum for the first time. This advanced surgical procedure shows the high potential of intramedullary photodynamic bone stabilization in patients with minor bone quality.
Sections du résumé
BACKGROUND
BACKGROUND
Surgical fracture treatment in patients suffering from "osteogenesis imperfecta" (OI) is challenging and often results in unsatisfactory fixation of implants due to altered bone quality. Even the use of locking plates bears a residual risk to develop a loss of reduction leading to secondary fracture dislocation. However, the augmentation with an intramedullary photodynamic bone stabilization system (PBS) (e.g. Illuminoss®) may increase bone stability and allow for a sufficient anchorage of established implants even in OI patients.
CASE PRESENTATION
METHODS
We report the case of a 41-year-old male patient with the diagnosis of OI. He sustained a medial femoral neck fracture (Garden type IV, Pauwels type III) and a fracture of the acetabulum (AO-Type 62-B.3) - both right-sided - after a blunt trauma during a bicycle accident. The medial femoral neck fracture was subsequently surgically treated to preserve the femoral head. After augmentation of the proximal femur with the PBS, a Dynamic Hip Screw (DHS) was implanted. After a short recovery, the acetabular fracture was surgically treated by intramedullary augmentation and locking plate fixation.The patient was discharged seven days after the surgical intervention of the acetabular fracture. Partial weight-bearing activities of the right lower extremity were performed on crutches for 6 weeks. The patient was able to do his outpatient rehabilitation program without any complications. He returned to work eight weeks after surgery. After a follow-up of four months, the patient presented full weight-bearing without assistance. No physical complaints were reported 14 months after surgery (Harris Hip Score 90).
CONCLUSION
CONCLUSIONS
To the best of our knowledge, we report the augmentation with a photodynamic bone stabilization system of internal fixation techniques in an OI patient with fractures of the femoral neck and the acetabulum for the first time. This advanced surgical procedure shows the high potential of intramedullary photodynamic bone stabilization in patients with minor bone quality.
Identifiants
pubmed: 31872019
doi: 10.1016/j.tcr.2019.100200
pii: S2352-6440(19)30034-2
pii: 100200
pmc: PMC6911912
doi:
Types de publication
Case Reports
Langues
eng
Pagination
100200Informations de copyright
© 2019 The Authors.
Références
Med Devices (Auckl). 2014 Dec 12;7:453-61
pubmed: 25540600
J Med Genet. 1979 Apr;16(2):101-16
pubmed: 458828
N Engl J Med. 1998 Oct 1;339(14):947-52
pubmed: 9753709
Anesthesiology. 2002 Oct;97(4):1011-3
pubmed: 12357173
Lancet. 2004 Apr 24;363(9418):1377-85
pubmed: 15110498