gms | German Medical Science

Objectives: The incidence of osteogenesis imperfecta (OI) is 1 for 10'000 to 20'000 births. People suffering from OI are known to be at more risk of fractures. Due to the bones deformity and weakness, treatment of fractures in patient with OI is a big challenge for orthopaedic surgeons.

Methods: We report a case of a patient with OI type III who presents with a displaced fracture of the femoral neck.

Results: A 52 year old patient with OI type III did an unexpected move while sitting in his wheel-chair and suddenly suffered from severe pain in his left hip. Typical OI-related varus deformity of both femora was found on examination in our emergency department. There was no neurologic impairment. X-rays showed a displaced femoral neck fracture with varus deformity - type III according to the Pauwels classification.

Previous to this incident the patient was able to walk a few meters with help and was using a wheel-chair the rest of the time. 4 days after the trauma the patient underwent a hemiarthroplasty of the left hip with valgus osteotomy of the proximal femur. The osteotomy was necessary to fit the femoral component to the shape of the proximal femur. The hospital stay after the surgery was 9 days.

6 weeks after the surgery he reported mild pain and was able to walk again a few meters. 3 months after the surgery he reports no pain and his ability to mobilize himself is back to the initial state, while the site of osteotomy shows signs of bony healing on x-ray.

Conclusions: Fracture of the neck of femur in patients with OI is rarely described. To our knowledge we report a very unique case of partial arthroplasty of the hip combined with valgus osteotomy of the proximal femur in a patient with OI.