![]() On postoperative Day 8, a dense seropurulent discharge started. Under fluoroscopy control, the operation was terminated ( Figure 3). During the operation, the drill bit broke once. As there was no good bone contact in the trochanteric region during the operation, allograft of 30 cc corticocancellous chips was applied. On postoperative Day 4, the patient was again taken in for surgery, the PFN was removed and fixation was made with a proximal femur plate (TST). On the radiograph taken on postoperative Day 1, the lag screw was seen not to be fixed in the femoral head ( Figure 2), so revision surgery was planned for the patient. Throughout the operation, particularly during the drilling, extreme difficulties were experienced.įluoroscopy checking was applied and the operation was concluded. One lag screw and one antirotation wedge were advanced in the femoral neck, and the distal screw was locked with two nails. The fracture was then reduced and fixation was made with one antirotation wedge PFN screw (TST ®, Turkey). ![]() During this process, the drill bit was broken twice and one of the broken drill bits remained in the medullary canal. The medulla was then drilled and opened with a series of reamers. The whole of the femur medulla was seen to be closed and sclerotic. The fracture line was opened with a longitudinal incision from the lateral. The aim of this paper was to present the difficulties and points requiring attention during the treatment of a patient with osteopetrosis tarda who developed infection following revision surgery for unsuccessful fixation with proximal femoral nailing (PFN) of a fracture in the proximal femur. Citation9, Citation10 Literature related to the treatment of osteopetrosis-related fractures is generally in the form of case reports. Infection together with a fracture makes diagnosis and treatment more difficult. The predisposition to infection is increased in patients with osteopetrosis. Although rare, osteopetrosis may complicate the treatment of fractures in such patients. As in other fractures, nonunion or varus malunion of these fractures may occur. Citation4 – Citation8 Internal fixation can be applied, although technical challenges may be experienced due to increased bone density. In the past, different treatment modalities have been attempted, but the ideal implant for the treatment of subtrochanteric fractures with osteopetrosis is still a matter for discussion. Citation4, Citation5 It is characterized by clinically minor trauma-related fractures and typical radiographic findings of failure of tubulation and a “bone within a bone” appearance. ![]() Citation3 Osteopetrosis tarda, which is also known as marble bone disease, is a subtype of autosomal dominant osteopetrosis type II. Citation3 The fractures most frequently involve the upper one-third of the femur and the tibia. Citation1, Citation2 The fragility of dense, sclerotic bones leads to an increased incidence of fractures. Citation1 Clinically, it is characterized by dense, sclerotic, and deformed bones. ![]() Osteopetrosis is a rare, inherited disease characterized by defects in osteoclastic function that results in defective bone resorption. ![]()
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