1Orthopedic Division, Department of Surgery, King Abdullah Specialized Children’s Hospital, Ministry of the National Guard‑Health Affairs, Jeddah, Saudi Arabia
2King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
3King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
4Orthopedic Surgery Department, King Abdullah Medical City, Makkah, Saudi Arabia
5Department of Surgery, Orthopedic Division, College of Medicine, Taif University, Taif, Saudi Arabia
6College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
Patients with congenital insensitivity to pain and anhidrosis (CIPA) exhibit an inability to perceive pain, recurrent fractures, self-mutilation, and impaired thermoregulation, which lead to severe complications and high morbidity. Children with CIPA often sustain multiple unnoticed fractures that may be mistaken for child abuse because of the presence of fractures at different stages of healing. If unrecognized or inadequately managed, these injuries can cause permanent damage. We report the case of a 9-year-old boy who presented with recurrent fractures, chronic osteomyelitis, heterotrophic ossification, and gangrene. This case underscores the need for heightened awareness among healthcare providers regarding the clinical manifestations and management challenges of CIPA. It also emphasizes the importance of early diagnosis, meticulous follow-up, and a multidisciplinary approach to optimize outcomes and prevent severe complications in affected children.
