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Case Reports in Orthopedics
Volume 2014, Article ID 548161, 5 pages
http://dx.doi.org/10.1155/2014/548161
Case Report

A Case of Femoral Fracture in Klippel Trenaunay Syndrome

Guy’s and St Thomas’ NHS Foundation Trust, St Thomas’ Hospital, Trauma Room, Ground Floor, Westminster Bridge Road, London SE1 7EH, UK

Received 13 May 2014; Revised 2 October 2014; Accepted 3 October 2014; Published 12 November 2014

Academic Editor: Hitesh N. Modi

Copyright © 2014 Sam Nahas et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We present a case of Klippel Trenaunay syndrome (KTS) who presented with severe bilateral knee osteoarthritis (OA). Preoperative planning was commenced for a total knee replacement (TKR). Whilst on the waiting list the patient suffered a fall and sustained a complete femoral diaphysis fracture. Conservative management in the form of skin traction was initially chosen as significant extra- and intramedullary vascular malformations posed an increased risk of perioperative bleeding. This failed to progress to union, and so open reduction and internal fixation was performed. This subsequently resulted in on-going delayed union, which was subsequently managed with low intensity pulsed ultrasound (LIPUS, otherwise known as Exogen (Bioventus. exogen. Secondary exogen, 2012)). There are only two previous documented cases of femoral fracture in KTS. This is the first report of a patient with this rare syndrome receiving this treatment. We discuss the management of fracture in this challenging group of patients.