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Archives of Orthopaedic and Trauma Surgery

, Volume 138, Issue 6, pp 783–789 | Cite as

Anterior cervical arthrodesis for chronic hangman’s fracture in a patient with osteopetrosis: a case report

  • Kentaro Yamane
  • Nobuo Kai
Trauma Surgery

Abstract

Introduction

Osteopetrosis is a clinical syndrome characterized by the failure of osteoclasts to resorb bone. Affected patients usually suffer from repetitive fractures due to this pathological state. Surgical treatment of these fractures is often complicated by the difficulty of working with the extremely hard and brittle bones. The purpose of this study was to report a case of chronic hangman’s fracture in a patient with osteopetrosis who underwent surgery for cervical anterior interbody fusion.

Materials and methods

A 76-year-old woman visited our institute 1 month after injury. Radiographs revealed a type II hangman’s fracture with severe translation according to the Levine–Edwards classification. We performed anterior spinal arthrodesis from C2 to C3.

Results

We obtained successful anterior C2–C3 arthrodesis without major complications, but encountered some surgical difficulties in treatment due to hard and brittle bones.

Conclusions

Anterior cervical arthrodesis can be considered an effective treatment for chronic unstable hangman’s fracture in patients with osteopetrosis. However, great care must be taken when performing surgery and continued follow-up is warranted.

Keywords

Hangman’s fracture Osteopetrosis Traumatic spondylolisthesis Internal fixation Complications 

Notes

Funding

There is no funding source.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Landa J, Margolis N, Di Cesare P (2007) Orthopaedic management of the patient with osteopetrosis. J Am Acad Orthop Surg 15(11):654–662CrossRefPubMedGoogle Scholar
  2. 2.
    Tolar J, Teitelbaum SL, Orchard PJ (2004) Osteopetrosis. N Engl J Med 351:2839–2849CrossRefPubMedGoogle Scholar
  3. 3.
    Shapiro F (1993) Osteopetrosis. Current clinical considerations. Clin Orthop Relat Res(294):34–44Google Scholar
  4. 4.
    Gupta RK (2005) Long bone fractures in osteopetrosis: awareness of primary pathology and appropriate pre-operative planning necessary to avoid pitfalls in fixation. Injury Extra 36(3):37–41CrossRefGoogle Scholar
  5. 5.
    Bhargava A, Vagela M, Lennox CM (2009) “Challenges in the management of fractures in osteopetrosis”! Review of literature and technical tips learned from long-term management of seven patients. Injury 40(11):1167–1171CrossRefPubMedGoogle Scholar
  6. 6.
    Chhabra A, Westerlund LE, Kline AJ, McLaughlin R (2005) Management of proximal femoral shaft fractures in osteopetrosis: a case series using internal fixation. Orthopedics 28(6):587–592PubMedGoogle Scholar
  7. 7.
    Gupta R, Gupta N (2001) Femoral fractures in osteopetrosis: case reports. J Trauma 51(5):997–999CrossRefPubMedGoogle Scholar
  8. 8.
    Armstrong DG, Newfield JT, Gillespie R (1999) Orthopedic management of osteopetrosis: results of a survey and review of the literature. J Pediatr Orthop 19(1):122–132PubMedGoogle Scholar
  9. 9.
    Auerbach JD, McCormick FL, Mehta S, Brummett RS, Rushton SA (2007) Posterior cervical arthrodesis for subacute odontoid fracture in a patient with osteopetrosis: case report. Spine (Phila Pa 1976) 32(1):E34-38CrossRefGoogle Scholar
  10. 10.
    Martin RP, Deane RH, Collett V (1997) Spondylolysis in children who have osteopetrosis. J Bone Joint Surg Am 79(11):1685–1689CrossRefPubMedGoogle Scholar
  11. 11.
    Westerlund LE, Blanco JS, Chhabra A (2000) Posterior spinal instrumentation and fusion of a neuromuscular scoliosis in a patient with autosomal dominant osteopetrosis. Spine (Phila Pa 1976) 15(2):265–267 25(CrossRefGoogle Scholar
  12. 12.
    Levine AM, Edwards CC (1985) The management of traumatic spondylolisthesis of the axis. J Bone Joint Surg Am 67:217–226CrossRefPubMedGoogle Scholar
  13. 13.
    Milgram JW, Jasty M (1982) Osteopetrosis: A morphological study of twenty-one cases. J Bone Joint Surg Am 64:912–929CrossRefPubMedGoogle Scholar
  14. 14.
    Suzuki S, Awaya G (1986) Stress fracture of the vertebral arch in osteopetrosis. Clin Orthop Relat Res 213:232–236Google Scholar
  15. 15.
    ElMiligui Y, Koptan W, Emran I (2010) Transpedicular screw fixation for type II Hangman’s fracture: a motion preserving procedure. Eur Spine J 19:1299–1305CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Li Z, Li F, Hou S, Zhao Y, Mao N, Hou T, Tang J (2015) Anterior discectomy/corpectomy and fusion with internal fixation for the treatment of unstable hangman’s fractures: a retrospective study of 38 cases. J Neurosurg Spine 22(4):387–393CrossRefPubMedGoogle Scholar
  17. 17.
    Ma W, Xu R, Liu J, Sun S, Zhao L, Hu Y, Jiang W, Liu G, Gu Y (2011) Posterior short-segment fixation and fusion in unstable Hangman’s fractures. Spine (Phila Pa 1976) 36:529–533CrossRefGoogle Scholar
  18. 18.
    Mammis A, Yanni DS, Thaker NG, Goldstein IM (2012) Reduction of displaced Hangman’s fracture by compression across crossed translaminar screws. J Clin Neurosci 19:582–584CrossRefPubMedGoogle Scholar
  19. 19.
    Strickland JP, Berry DJ (2005) Total joint arthroplasty in patients with osteopetrosis: a report of 5 cases and review of the literature. J Arthroplasty 20:815–820CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Orthopaedic SurgeryNational Hospital Organization Fukuyama Medical CenterFukuyamaJapan

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