ABSTRACT
There is an emerging body of evidence showing that young patients, post haematopoietic stem cell transplantation (HSCT), can develop skeletal changes that mimic an osteochondrodysplasia process. The key discriminator is that these children have had otherwise normal growth and skeletal development before the therapeutic intervention (HSCT), typically for a haematological malignancy. Herein we present that case of a boy who underwent HSCT for Haemophagocytic Lymphohistiocytosis (HLH) aged 2 years. Following Intervention with HSCT this boy's growth has severely decelerated (stature less than 1st centile matched for age) and he has developed a spondyloepiphyseal dysplasia.
Subject(s)
Hematopoietic Stem Cell Transplantation , Lymphohistiocytosis, Hemophagocytic , Osteochondrodysplasias , Humans , Hematopoietic Stem Cell Transplantation/adverse effects , Male , Osteochondrodysplasias/genetics , Osteochondrodysplasias/pathology , Child, Preschool , Lymphohistiocytosis, Hemophagocytic/genetics , Lymphohistiocytosis, Hemophagocytic/pathology , Lymphohistiocytosis, Hemophagocytic/etiology , Growth Disorders/pathology , Growth Disorders/etiology , Growth Disorders/geneticsABSTRACT
BACKGROUND: Locking compression plates have become increasingly popular in orthopaedic surgery. However, the gold standard of treatment for distal fibular fractures remains fixation with a non-locking one-third tubular plate. It has been reported that locking plates in distal fibular fractures are associated with an increased complication rate. HYPOTHESIS: The objective of this study is to assess the complication rates of locking versus non-locking plates in patients who underwent surgical fixation of distal fibular fractures. MATERIALS & METHODS: A retrospective analysis of closed distal fibular fractures that underwent surgical repair over a 2-year period with either a locking or non-locking plate was undertaken, analysing the groups for both wound and overall postoperative complications. RESULTS: A total of 160 patients were treated over 2 years, of which 129 and 31 patients were treated with non-locking and locking plates respectively. There was no significant difference between the non-locking and locking plates overall complication rates (13.5% versus 15.4%, p=0.76) or wound complication rates (3.97% versus 3.85%, p=1.00). DISCUSSION: Distal fibular fractures managed with locking plates do not have a higher complication rate in comparison to those managed with non-locking plates. LEVEL OF EVIDENCE: III (case control study).
