Bone plating in patients with type III osteogenesis imperfecta: results and complications

Area of Science:

• Pediatric Orthopedics
• Skeletal Dysplasias
• Biomaterials in Medicine

Background:

• Osteogenesis imperfecta (OI) type III presents significant challenges in pediatric bone management.
• Traditional bone plating is a common surgical intervention for fractures and deformities in OI.
• The efficacy and complication rates of bone plating in skeletally immature patients with OI require further investigation.

Purpose of the Study:

• To analyze the outcomes of bone plating in children with osteogenesis imperfecta type III.
• To compare the complication and revision rates of bone plating versus elongating intramedullary rods.
• To evaluate the long-term effectiveness of bone plating in this patient population.

Main Methods:

• Retrospective analysis of four children (6 femurs, 2 tibias) with osteogenesis imperfecta type III treated with bone plating.
• Detailed review of operative reports, complication data, and revision procedures.
• Comparison of outcomes with historical data on elongating intramedullary Bailey-Dubow rods.

Main Results:

• A total of 13 bone platings were performed across eight bones, with an average age of 44 months at initial operation.
• Average time to revision was 27 months, with common indications including fracture (6), deformity (3), and hardware failure (3).
• All eight bones were ultimately revised to elongating intramedullary rods, indicating initial treatment failure with plating.

Conclusions:

• Bone plating in skeletally immature patients with osteogenesis imperfecta type III does not yield superior outcomes compared to elongating rods.
• Higher rates of refracture and hardware failure necessitate revision surgery, suggesting bone plating is less effective for OI.
• Elongating intramedullary rods appear to be a more reliable and durable treatment option for managing long bone deformities in pediatric osteogenesis imperfecta.