A series of twenty-three pathological fractures in nine children who had
Gaucher disease was reviewed. Infiltration of the medullary space by
Gaucher cells, erosion of bone, osteonecrosis in the area of the fracture,
and disuse osteoporosis were the main etiological factors. Bone scans
indicated that the osteonecrosis was due to osseous ischemia that occurred
two to twelve months before the pathological fracture. Fracture-healing was
prolonged, taking as long as two years for completion in some patients.
Inadequate periods of immobilization and early weight-bearing led to
malunion.