Fractures in transfusion dependent beta thalassemia--an Indian study

To analyse the incidence of fractures in beta thalassemia patients and to identify causative factors.

We examined all cases of transfusion dependent beta thalassemia (TDBT) seen at our institute over a two-year period. The transfusion records, incidence of fractures, cause of fracture and Hb levels were recorded. Radiographs of the involved parts were taken in cases with fractures only.

Amongst 105 cases of TDBT assessed, 14 sustained a total of 28 fractures. Seven patients sustained more than one fracture. Two thirds of these fractures were caused by trivial trauma. All fractures, except one, were of the closed type. Radiologically, fractures frequently showed minimal or no displacement. All fractures were successfully treated by closed modalities of treatment. Majority of the fractures healed within normal union time for a given bone. Permanent deformities and gross limb length discrepancies were uncommon. On reviewing the literature, we noted that the incidence of fractures in our series and in the latest reports was lesser than previously reported. We postulate that this is a result of better and earlier control of hemoglobin status by improved transfusion techniques, and earlier recognition of the disease. Difficulties arise due to inadequate blood transfusion facilities in developing countries.