Pathological hip fracture of pediatric age. Revision of the cystic angiomatosis of the bone

INTRODUCTION: Bone cystic angiomatosis is a disease with only 200 cases described, based on angiomatous nonmalignant proliferation, in bone tissue and viscera. It focuses on pelvis, long bones and scapular waist. Clinical evolution ranges from self-limiting forms to massive aggressive osteolysis (Gorham-Stout).Its diagnosis is of exclusion, with nonspecific clinical, radiological (lytic images) and histopathological findings. CASO CLINICO: Nuestro estudio se basa en el caso clinico de un paciente de 14 anos diagnosticado con angiomatosis quistica osea, con afeccion osea diseminada, que vino a nuestro centro por el dolor y la impotencia funcional en la cadera derecha, diagnosticando una fractura pertrocanterea. Se le hizo una osteosintesis con tornillo deslizante de la placa VERSA de cuatro agujeros. Se utilizo un injerto alogenico de hueso esponjoso de la cabeza femoral. La evolucion fue satisfactoria con ambulacion a plena carga por mes sin requerir medicacion analgesica y control de rayos X a los ocho meses, los cuales mostraron signos de completa integracion del injerto. La escala analgesica del dolor (EVA) mostro una puntuacion de 2/10 por mes. DISCUSSION: There is controversy regarding the treatment of these fractures by osteosynthesis with bone graft. We are facing a case without serious clinical criteria, but with multiple foci of osteolysis. It was decided not to intervene prophylactically the contraleteral hip, since it is asymptomatic and there are different patterns of evolution described in the literature and risks in surgery.