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It is a medical condition characterized by asymmetrical long bone bowing with a “beaten-metal” appearance of the skull, dolichomacrocephaly, and ocular hypertelorism.
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Bowing of Long Bones, Asymmetrical and Symmetrical.
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This is a very rare disorder and the exact incidence is unknown. There are only few cases described in the literature.
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Most cases are sporadic. An autosomal dominant inheritance has been suggested.
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Diagnosis and Clinical aspects
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Two sibs with congenital asymmetrical long bone bowing and one with congenital symmetrical long bone bowing were described. Other abnormalities included beaten-metal appearance of the skull, dolichomacrocephaly, ocular hypertelorism, and bone-within-bone appearance of vertebrae. Differential diagnosis must be made with camptomelic dysplasia, kyphomelic dysplasia, hypophosphatasia, Grant Syndrome, and osteogenesis imperfecta.
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Anesthetic considerations
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This illness is a special mild form of the other bone dysplasia genetic syndromes and has no special repercussion on anesthesia technique, with the potential exception of positioning and access for locoregional anesthesia.
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Other conditions to be considered
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☞Grant Syndrome: Persistent wormian bones, blue sclerae, mandibular hypoplasia, shallow glenoid fossae, camptomelia, and hypotonia. Apparently, it is an autosomal dominant trait.
☞Osteogenesis Imperfecta: Inherited disease responsible for varying degrees of skeletal fragility. Minimal trauma is sufficient to cause fractures and bone deformities.
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Moore
LA, Moore
CA, Smith
JA,
et al: Asymmetric and symmetric long bone bowing in two sibs: An apparently new bone dysplasia.
Am J Med Genet 47:1072, 1993.
[PubMed: 8291526]