Module 20, General Orthopaedist Level

This 9 year old boy presented with the diagnosis of osteogenesis imperfecta. By age nine he sustained 16 fractures in his lower extremities and 30 fractures in his upper extremities. He started walking at 18 months of age. He now complains of pain in the ankle. At this time he is a household and minimal community ambulator.

Question 20A

A non-weight bearing cast for eight weeks is placed.

Question 20B

Because he is nine and has been walking since age 18 months you can be confident to the parent and the boy that this is a minimal fracture and will again be walking after it heals.

Question 20C

An x-ray of his femur demonstrates a shaft diameter of 15 mm which suggests that he has adequate bone for weight bearing and continued walking.

Question 20D

Internal fixation of the fracture would allow the most rapid healing and weight bearing.

Question 20E

This poor bone will heal very slowly so you tell the family to expect at least 12 weeks for complete healing.

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