Abstract
A case of 23-month-old boy with congenital insensitivity to pain with anhidrosis (CIPA) suf-fered from frequent fractures was reported.
A diagnosis of CIPA was made at the age of two months. He was brought to our hospital be-cause of sudden disability of walking for unknown reason at the age of 23 months. Roentogenographic examination revealed the left tibial fracture. Since then he has had many fractures. His fractured bones were hard to keep immobile with plaster due to insensitivity to pain. So fractures resulted in delayed union, pseudoarthrosis and osteonecrosis. Osteomyelitis following wounds on fingers by self-mutilation was cured with conservative treatment, but purulent arthritis of right ankle following upper respiratory infection required surgical approach to cure. These findings suggested that bones were easy to fracture and to be infected because there was insensitivity to pain. And once either fracture or infection happened, it was hard to cure and became worse. So it is necessary for us to do careful treatment and follow-up and instruct to patient's family in orthopaedic cares.
