Serial drilling technique for sequential subtrochanteric femur fracture fixation in pediatric osteopetrosis: a technical report.

Authors

• Adam Mansour
• Josiah J Wolf
• Ivan Slyepkan
• Morgan Turnow, OhioHealth
• Michael Anderson, OhioHealth
• Anthony Wing, OhioHealth
• Jack Iandoli, OhioHealth
• Craig Goubeaux, OhioHealth
• Craig Smith
• Allen Kadado

Document Type

Article

Publication Title

OTA international : the open access journal of orthopaedic trauma

Abstract

Pediatric osteopetrosis presents a significant technical challenge for fracture fixation due to the bone's dense yet brittle nature and frequently absent medullary canal. Traditional drilling methods risk excessive torque, drill-bit breakage, and iatrogenic fractures. Here, we describe a serial drilling technique for plate-and-screw fixation in a 5-year-old child with osteopetrosis who sustained sequential subtrochanteric femur fractures 8 months apart. By creating a small pilot hole, sequentially enlarging it with intermediate bits under copious irrigation, and inserting locking screws manually, we achieved stable fixation with no observed instrument failure or intraoperative complications. This method may provide a practical technical strategy for surgeons managing similarly dense osteopetrotic bone.

First Page

496

Last Page

496

DOI

10.1097/OI9.0000000000000496

Publication Date

7-7-2026

Recommended Citation

Mansour A, Wolf JJ, Slyepkan I, Turnow M, Anderson M, Wing A, Iandoli J, Goubeaux C, Smith C, Kadado A. Serial drilling technique for sequential subtrochanteric femur fracture fixation in pediatric osteopetrosis: a technical report. OTA Int. 2026 Jul 7;9(3):e496. doi: 10.1097/OI9.0000000000000496. PMID: 42441352; PMCID: PMC13337027.