Subtrochanteric Femoral Fracture in a Patient with Osteopetrosis: Treated with Internal Fixation and Complicated by Intraoperative Femoral Neck Fracture

Figures & data

Table 1 Characteristics of Three Types of OP

Type	ADO	ARO	IAO
Severity	Benign	Malignant	Intermediate
Inheritance	Autosomal dominant	Autosomal recessive	Autosomal recessive
Prevalence	1/20,000	1/250,000	Extremely rare
Diagnosis	Incidentally	Early infancy	–
Main Complaints	Increased risk of fractures, infection, cranial nerve defects	Bleeding disorder and/or sepsis	Increased risk of fractures, infection

Figure 1 X-ray examination results of the pelvis showed a right subtrochanteric femoral fracture and osteosclerosis of the pelvis with bone-within-bone appearance in the iliac wing and obliteration of the femoral medullary canal.

Figure 2 Anteroposterior radiograph of the lumbar spine (A) showed the appearance of a “rugger jersey spine ”caused by thickening of vertebral endplates. Anteroposterior radiograph of right knee (B) showed no “Erlenmeyer flask” deformity of the distal femur.

Figure 3 Postoperative radiographs of the pelvis (A, B) showed the right subtrochanteric femoral fracture with a dynamic hip screw and fracture of the right femoral neck.

Figure 4 The X-ray examination results (A, B) showed complete healing of the subtrochanteric fracture and femoral neck fracture 2 years after surgery.

Table 2 Summary of the Published Cases Describing the Surgical Treatment of Subtrochanteric Femoral Fractures in Patients with OP (2010–2020)

Article	Age	Gender	Fracture Localization	Implant	Complication	Follow-Up Period
Golden et al(2010)^Citation21	27	M	Bilateral subtrochanteric	DCS	Delayed union	3 years
Amit et al(2010)^Citation22	35	F	Right subtrochanteric	LCP	Contralateral stress fracture	23 weeks
	38	F	Left subtrochanteric	LCP	None	21 weeks
Sonohata et al(2011)^Citation23	61	F	Right subtrochanteric	HA	Delayed union	2 years
Kumar et al (2012)^Citation24	45	M	Bilateral subtrochanteric	DHS	Delayed union	11 months
Kumbaraci et al(2013)^Citation25	21	F	Bilateral subtrochanteric	IMN	Delayed union	12 months
Sen et al (2013)^Citation26	Mean 26	4 M/1 F	4 subtrochanteric(1 bilateral)	LCP	None	3 months
Aslan et al (2014)^Citation27	24	F	Bilateral subtrochanteric	Plate-screw	None	12 months
Seyfettinoglu et al (2016)^Citation28	49	F	Left subtrochanteric	IMN	Infection	12 months
Huang et al (2017)^Citation29	67	M	Left subtrochanteric	LCP	Delayed union	12 months
Matsuo et al (2018)^Citation30	27	M	Right subtrochanteric	LCP	Non-union	32 months
Hasan et al (2018)^Citation31	23	M	Right subtrochanteric	LCP	None	7 months
Chawla et al (2019)^Citation32	39	M	Right subtrochanteric	DCS	None	12 months
	40	M	Left subtrochanteric	DCS	Delayed union	12 months
	35	M	Left subtrochanteric	LCP	Non-union and peri-implant stress fracture	4 years
Hiyama et al (2020)^Citation33	38	M	Left subtrochanteric	LCP	Delayed union	7 years
	79	F	Left subtrochanteric	LCP	Delayed union	8 years
Kim et al (2020)^Citation34	26	M	Left subtrochanteric	IMN	Delayed union	30 months
	70	F	Bilateral subtrochanteric	IMN(left) and LCP(right)	Delayed union	20 months

Abbreviations: M, male; F, female; DCS, dynamic condylar screw; LCP, locking compression plate; HA, hemiarthroplasty; DHS, dynamic hip screw; IMN, intramedullary nail.

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