Simple reproducible technique in treatment for osteopetrotic fractures

Osteopetrosis is a rare skeletal condition first described by German radiologist Heinrich Albers-Schonberg. The most important technical difficulty is drilling due to hard bone in patients with osteopetrosis; recommendations have been made to use high-speed electric drill bits. But, the unavailability of this special drill bit in most of the centres makes the job more difficult. The study was conducted from 2009 to 2012; the cases are selected from Outpatients Department of Postgraduate Institute of Medical Education and Research. The patients were in the age group of 10-50 years with a mean age of 26 years. Five cases were included in the study: four patients had subtrochanteric fractures, and one had segmental fracture of the humerus. Open reduction and internal fixation was done in all the fractures using metal-cutting drill bit. The use of metal-cutting drill bit in osteopetrosis not only made our job easy but also prevented thermal necrosis of the bone to a large extent. The union rate was 100 % in our series, and there was no infection in any of our cases. In the treatment for fractures in osteopetrosis, the use of a metal-cutting drill bit along with careful attention to drilling technique can help avoid bit breakage and thermal bone injury that may produce ring sequestrum or destroy the already scant osteogenic cells.