Peri-Implant Fracture In Osteopetrosis – A Case Report

Abstract

We report a case of osteopetrosis complicated by a left proximal femur peri-implant fracture with broken implants. The patient underwent implant removal followed by open reduction and internal fixation using a contralateral distal femur locking compression plate. Osteopetrosis is characterized by increased bone density and brittleness, making fracture fixation challenging. Preoperative planning is essential to minimize operative time and reduce intra-operative complications, which are more likely due to the unique bone quality. During surgery, careful consideration of the bone’s brittleness and hardness guided the approach, emphasizing the importance of gentle manipulation and appropriate selection of implants. Conventional plating techniques remain the cornerstone of fracture management in osteopetrosis, but the unique challenges of this disease require the surgeon to be vigilant about potential hardware failure. Fracture union was eventually achieved at 18 months, illustrating the prolonged healing time often seen in this rare metabolic bone disorder. The extended period to union highlights the need for intensive postoperative care and regular monitoring to detect potential complications early. This case underscores the necessity of individualized surgical strategies and the importance of a multidisciplinary approach to managing osteopetrosis-related fractures. Postoperative rehabilitation and patient education play crucial roles in ensuring optimal outcomes in these patients.