[Spontaneous fracture of an atrophied mandible].
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This report deals with the treatment of 31 spontaneous fractures which occurred in 50 institutionalized patients who were bedridden primarily because of severe cerebral palsy associated with brain injury. More than one-half of the group sustained a spontaneous fracture. Satisfactory healing of all fractures with a minimum of complications occurred without any immobilization or realignment. In 4 patients with delayed compound wounds, the treatment consisted of resection of the protruding portion of the bone after allowing the bony protrusion to wall itself off.
This report describes a patient in whom sequential pathological fractures occurred at sites of plasma cell malignant bony deposits, but in which clinical and radiological healing occurred without treatment at the site of the initial deposit.
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The recommended regimen of etidronic acid (disodium etidronate) for the treatment of Paget's disease of bone is 5mg/kg/day for a period of less than six months. There have, however, been reports of impaired mineralisation of bone and concern that the risk of fracture is increased with this dosage. We report a patient with Paget's disease in whom fractures occurred through pagetic and non-pagetic bone which appeared to be causally related to treatment with lose doses of etidronic acid. The osteomalacia resolved when etidronic acid was discontinued.
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