Skeletal complications in congenital insensitivity to pain and anhidrosis: a problem to reckon with

Author(s):  
Vaibhav Tandon ◽  
Radhika Sanjay Lotlikar ◽  
Sruthi S. Nair ◽  
Sabrish Sekar ◽  
Soumya Sundaram
2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Soroush Baghdadi ◽  
Sadegh Saberi ◽  
Taghi Baghdadi

Abstract Background Orthopedic manifestations of congenital insensitivity to pain (CIP) can be devastating if left untreated. Knee deformities are common in patients with CIP and might lead to joint destruction and loss of walking ability. The purpose of the present study was to report the results and complications of guided growth procedures around the knee in patients with CIP. Methods In a retrospective review, all patients with CIP who underwent guided growth procedures around the knee from 2009 to 2017 at a tertiary referral hospital were evaluated. Patients with secondary insensitivity to pain (e.g., syringomyelia), as well as patients with incomplete records, were excluded. Demographic data, clinical findings, correction rate, and complications were recorded. Results Ten knees in six patients fulfilled the inclusion criteria. The median age was 10 (range, 5–12), with a mean follow-up of 31 months (range, 16–56). Distal femoral tension-band hemiepiphysiodesis was the most common procedure, followed by proximal tibial hemiepiphysiodesis. The mean correction rate was 0.28°/month for femoral deformity. Staples were removed prematurely in one patient due to extrusion. No cases of infection or skin dehiscence were observed. None of the patients needed a reconstructive knee procedure during the study period. Conclusions The findings of this study suggest that guided growth procedures might have a role in the correction of knee deformities in patients with CIP. However, the correction rate is lower than that of typically developing children, patients should be closely followed to prevent complications, and stringent patient selection criteria should be followed to ensure success.


2017 ◽  
Vol 45 (2) ◽  
pp. 549-555 ◽  
Author(s):  
Ting Wang ◽  
Haibo Li ◽  
Jingjing Xiang ◽  
Bin Wei ◽  
Qin Zhang ◽  
...  

Objective To explore the aetiology of congenital insensitivity to pain with anhidrosis (CIPA) in two Chinese siblings with typical CIPA symptoms including insensitivity to pain, inability to sweat, and self-mutilating behaviours. Methods Clinical examination and genetic testing were conducted of all available family members, and the findings were used to create a pedigree. Mutation screening using PCR amplification and DNA Sanger sequencing of the entire neurotrophic tyrosine kinase receptor type 1 gene ( NTRK1) including intron–exon boundaries was used to identify mutations associated with CIPA. Results A novel nonsense mutation (c.7C > T, p. Arg3Ter) and a known splice-site mutation (c.851-33 T > A) were detected in NTRK1 and shown to be associated with CIPA. Conclusion Our findings expand the known mutation spectrum of NTRK1 and provide insights into the aetiology of CIPA.


2017 ◽  
Vol 22 (2) ◽  
pp. 92-99 ◽  
Author(s):  
Tai-Seung Nam ◽  
Wenting Li ◽  
Somy Yoon ◽  
Gwang Hyeon Eom ◽  
Myeong-Kyu Kim ◽  
...  

2021 ◽  
Vol 10 (03) ◽  
pp. 1-4
Author(s):  
Pan Zhou ◽  
Chao Liu ◽  
Jinpei Yang ◽  
Shuai Zheng ◽  
Xueshi Li ◽  
...  

2014 ◽  
Vol 49 (2) ◽  
pp. 177-179 ◽  
Author(s):  
Ahmet Kagan Ozkaya ◽  
Ekrem Guler ◽  
Elif Arik ◽  
Ali Riza Namli ◽  
Derya Cevizli ◽  
...  

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