Management of a Fracture in a Known Case of Gorham's Vanishing Bone Disease
We present the case of a right handed construction worker
who has sustained two fractures in his left forearm. In 1990 he sustained a wrist fracture
which failed to heal. The bone of the distal radius, ulna and carpus was re-absorbed. In
1995 he had radiotherapy and a free vascularized fibular graft from proximal ulna to 2nd
metacarpal resulting in fusion of his left wrist and forearm but resolution of the injury.
The history and a bone biopsy showing intense neovascularity together made the diagnosis
of Gorham's Disease. He injured himself again in 1998 sustaining a fracture of the left
olecranon process. A bone biopsy at the time of internal fixation confirmed that the bone
was affected by his condition. Aggressive adjunctive therapy was initiated immediately
following the surgery and included electrical stimulation, osteoclast inhibitory therapy
and radiotherapy. At three months post injury the patient had painless function of his
elbow and returned to work against advice. !
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© 1998 Author(s) Hold Copyright