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Management of Stress Fracture in the Femoral Neck with an Existing Implant in Osteogenesis Imperfecta: A Case Report

Original Article | Volume 11 | Issue 3 | September-December 2025 | Page: 10-15 | Venkatadass K, Mithun D DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.244 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2025; The Author(s). Submitted: 14/04/2025; Reviewed: 07/05/2025; Accepted: 12/08/2025; Published: 10/12/2025 Authors: Venkatadass K MS Ortho [1], Mithun D MS Ortho [1] [1] Department […]

Patterns, Anatomical Distribution and Etiologies of Paediatric Fractures in a Tertiary Care Hospital in Sana’a City, Yemen: A Five-Year Retrospective Analysis

Original Article | Volume 11 | Issue 3 | September-December 2025 | Page: 2-9 | Ahmed S. Hudna, Mohammed M. Al-Zuhairi, Reham M. Mohammed1, Yahya M. Farwan, Abdulrahman Y. khamis, Kamal W. Yousef, Zinab A. Al-wardi DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.242 Open Access License: CC BY-NC 4.0 Copyright Statement: Copyright © 2025; The Author(s). Submitted: 15/08/2025; Reviewed: 08/09/2025; […]

Management of Stress Fracture in the Femoral Neck with an Existing Implant in Osteogenesis Imperfecta: A Case Report

Patterns, Anatomical Distribution and Etiologies of Paediatric Fractures in a Tertiary Care Hospital in Sana’a City, Yemen: A Five-Year Retrospective Analysis

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Management of Stress Fracture in the Femoral Neck with an Existing Implant in Osteogenesis Imperfecta: A Case Report

DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.244

Open Access License: CC BY-NC 4.0

Submitted: 14/04/2025; Reviewed: 07/05/2025; Accepted: 12/08/2025; Published: 10/12/2025

Authors: Venkatadass K MS Ortho [1], Mithun D MS Ortho [1]

[1] Department of Paediatric Orthopaedics, Ganga Medical Centre and Hospitals Pvt. Ltd., Coimbatore, Tamil Nadu, India.

Address of Correspondence
Dr. Mithun D,
Department of Paediatric Orthopaedics, Ganga Medical Centre and Hospitals Pvt. Ltd., Coimbatore, Tamil Nadu, India.
E-mail: dr.mithun_ortho@yahoo.com

Abstract

Introduction: Stress fracture of the neck of the femur with implant in-situ in osteogenesis imperfecta is not reported, and the management of such a scenario could be challenging. Often, the size of the neck in these patients poses a challenge regarding surgical technique and implant selection.
Case Presentation: An 18-year-old male, diagnosed to have osteogenesis imperfecta, presented with chronic left hip pain after sudden abnormal loading to the hip joint. He was diagnosed to have stress fracture of the neck of left femur despite a screw in the neck through a reconstruction type of interlocking nail spanning the femur. He was treated by valgus osteotomy and extra-cortical fibular strut grafting and fixation with a paediatric valgus osteotomy plate. Both the fracture and the osteotomy healed well and our patient had a satisfactory outcome and returned to his pre-fracture functional status.
Discussion: The management of stress fractures in hips with abnormal morphology is challenging, especially in the presence of a retained implant. In patients with osteogenesis imperfecta, bone size may be significantly decreased, impacting the surgical fixation technique.
Conclusion: This rare case illustrates that a stress fracture can happen in the neck of femur with coxa vara even when the neck is protected with a screw. Correction of coxa vara, which in turn normalizes the weight-bearing forces across the neck, is the key to success in this patient group.
Keyword: Osteogenesis, Imperfecta, Neck, Femur, Fracture, Stress.

References

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How to Cite this Article: Hudna AS, Al-Zuhairi MM, Mohammed RM, Farwan YM, Khamis AY, Yousef KW, Al-wardi ZA. Patterns, Anatomical Distribution and Etiologies of Paediatric Fractures in a Tertiary Care Hospital in Sana’a City, Yemen: A Five-Year Retrospective Analysis. International Journal of Paediatric Orthopaedics. September-December 2025; 11(3): 02-09

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Patterns, Anatomical Distribution and Etiologies of Paediatric Fractures in a Tertiary Care Hospital in Sana’a City, Yemen: A Five-Year Retrospective Analysis

DOI- https://doi.org/10.13107/ijpo.2025.v11.i03.242

Open Access License: CC BY-NC 4.0

Submitted: 15/08/2025; Reviewed: 08/09/2025; Accepted: 09/11/2025; Published: 10/12/2025

Authors: Ahmed S. Hudna MD [1], Mohammed M. Al-Zuhairi MBBS [2], Reham M. Mohammed MBBS [1], Yahya M. Farwan MBBS [3], Abdulrahman Y. Khamis MBBS [4], Kamal W. Yousef MBBS [4], Zinab A. Al-wardi MBBS [5]

[1] Department of Paediatrics, Faculty of Medicine and Health Sciences, University of Science and Technology (USTY), Sana’a, Yemen.
[2] Department of Obstetrics, Al-Thawra Modern General Hospital, Sana’a, Yemen
[3] Department of Surgery, University of Science and Technology Hospital, Sana’a, Yemen
[4] Department of Medicine, University of Science and Technology Hospital, Sana’a, Yemen
[5] Al-Aliaa International Hospital, Sana’a, Yemen

Address of Correspondence
Dr. Ahmed Saleh Hudna,
Associate Professor of Paediatrics, Faculty of Medicine and Health Sciences, University of Science and Technology. Sana’a, Yemen,
drahmedhudna@gmail.com

Abstract

Background: Fractures in children are a major global health concern, contributing to morbidity, healthcare burden, and potential long-term disability. In Yemen, the epidemiology and management of paediatric fractures remain poorly documented. Therefore, this study aimed to investigate the patterns, anatomical distribution, etiologies and concomitant injuries associated with paediatric fractures over a five-year period from 2020 to 2024.
Methods: A retrospective cross-sectional study was conducted at the University of Science and Technology Hospital in Sana’a between January 2020 and December 2024 involving 466 medical records of children aged ≤18 years and with documented fractures. Data on demographics, fracture characteristics, etiology, and associated systemic injuries were extracted using a structured data collection sheet. Data were summarized using appropriate descriptive statistics.
Results: Among 466 children with fractures, the majority were boys (78.8%). The mean age was 11.0 ± 4.4 years, with 52.8% aged ≤11 years. Fractures were almost equally distributed between left and right sides (50.6% vs. 49.4%) and upper and lower limbs (46.6% vs. 45.3%), with pelvic fractures being rare (0.9%). Single fractures predominated (68%), while 32% involved multiple fractures; 7.3% had fractures at multiple anatomical sites. In the upper limbs, the radius (32.2%) and humerus (29.4%) were most frequently fractured. In the lower limbs, the femur (40.1%) and tibia (35.5%) fractures predominated. Multiple-site fractures most often involved phalanges of the hand with the tibia and fibula (26.5%). Quotidian injuries were the leading cause (72.1%), followed by road traffic accidents (21.5%). Concomitant injuries occurred in 4.5% of cases, primarily affecting the nervous system (76.2%).
Conclusions: Paediatric fractures in Sana’a predominantly affected boys and children aged ≤11 years, with an almost equal distribution between limbs and sides. The radius, humerus, femur, and tibia were most frequently affected. Injuries sustained during routine activities were the leading cause, followed by road traffic accidents. Concomitant injuries, mainly neurological were uncommon.
Keywords: Paediatric fractures, Daily-life injuries, Sport injuries, Yemen

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