Presentation
Left thigh pain secondary to an accident during water therapy in a pool. Medical history include osteogenesis imperfecta.
Patient Data
There is diffuse osteopenia.
Oblique fracture of the left femoral diaphysis with 5.7 cm overlap between fragments with lateral and anterior apex angulation.
Lower femoral transverse sclerotic lines (Zebra lines).
Knee joint appears intact.
Soft tissue swelling at the left thigh.
Case Discussion
This represents a distal femoral fracture. The patient underwent left femur open reduction internal fixation and retrograde intramedullary fixation with flexible rods. Orthopedic follow-up was subsequently required.
The case shows typical radiological features of osteogenesis imperfecta with severe osteopenia of the examined bones, Zebra lines and pathological fracture.
The zebra stripe sign occurs when children with osteogenesis imperfecta have been treated with cyclical bisphosphonate therapy. When the drug is delivered in cycles, dense bone is formed while treatment is being given. This results in dense stripes across the metaphyses of bones which can be visualized radiographically.
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