Conservative Treatment or Surgical Treatment: A Case Report and Literature Review of Multiple Fractures of the Lower Extremities in a Child with Insensitivity to Pain

Autor:	Xiao‐lin Shi, Dong‐peng Tu, Zheng Liu, Yi-Kang Yu, Chao Xu, Xin Fan
Jazyk:	angličtina
Rok vydání:	2020
Předmět:	Male medicine.medical_specialty Pain Insensitivity Congenital Fractures Multiple Psychological intervention Case Report Disease Conservative Treatment NTKRI gene Congenital pain insensitive 03 medical and health sciences Comprehensive treatment 0302 clinical medicine lcsh:Orthopedic surgery Hereditary sensory autonomic neuropathy Arthropathy medicine Humans Orthopedics and Sports Medicine Multiple fractures Surgical treatment 030222 orthopedics business.industry medicine.disease Conservative treatment lcsh:RD701-811 Fracture Lower Extremity Child Preschool Orthopedic surgery Physical therapy Surgery Congenital Pain Insensitivity business 030217 neurology & neurosurgery
Zdroj:	Orthopaedic Surgery, Vol 12, Iss 3, Pp 1010-1015 (2020) Orthopaedic Surgery
ISSN:	1757-7853 1757-7861
Popis:	Congenital pain insensitivity is a rare genetic disease and its clinical manifestations are many. In orthopaedics, common complications of this disease include painless fracture and Charcot's arthropathy. We followed up a case of multiple fractures of the lower extremity in two years, during which time he came to the clinic for five painless fractures of the lower extremity in a total of six parts. A mutation was found on the NTKRI gene (chr1:156813923(hg19), NM_001007792.1: c.1221938C > T). We have developed a combination of surgery and conservative treatments for his condition, focusing on the mental state of the child and considering comprehensive treatment to be the best option for this type of patient. Occult fractures caused by pain insensitivity are often treated only as fractures, however their complications require routine examination and cleaning, suitable protective shoes, splint fixation, stretching, guided exercise planning, and early treatment of injuries. Due to the risk of fracture in the future, it is important that parents pay attention to the behavior and psychology of the child, such as not letting the child participate in exercise with a risk of injury, protective measures while playing, engaging in psychological counseling, and inducing interest in mental activity. These interventions will play a very important role in preventing the recurrence of fracture.
Databáze:	OpenAIRE
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