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Radial head dislocation and subluxation in osteogenesis imperfecta.
Alice Marcdargent Fassier1, Frank Rauch, Mehdi Aarabi
1Pediatric Orthopaedics Clinical Fell, McGill University, 1529 Cedar Avenue, Montreal, QC H3G 1AG, Canada. amarcdargent@shriners.mcgill.ca
The Journal of Bone and Joint Surgery. American Volume
|December 7, 2007
Summary
Radial head malalignment is frequent in osteogenesis imperfecta, particularly type V, and is linked to upper limb bowing and function impairment. Surgical correction of bowing may benefit selected patients.
Area of Science:
- Orthopedics
- Pediatric Orthopedics
- Genetics
Background:
- Osteogenesis imperfecta (OI) is a genetic disorder characterized by brittle bones.
- Upper limb deformities in children with OI can significantly impact their functional abilities.
Purpose of the Study:
- To determine the prevalence of radial head malalignment in various types of osteogenesis imperfecta.
- To identify factors associated with radial head malalignment in pediatric OI patients.
Main Methods:
- Retrospective analysis of 489 upper limbs from 254 patients with different types of osteogenesis imperfecta.
- Radiographic assessment for radial head malalignment, associated abnormalities, and limb deformations.
- Measurement of forearm range of motion and grip strength in a subset of patients.
Main Results:
- Radial head malalignment (dislocation or subluxation) was observed in 44 and 39 upper extremities, respectively.
- Malalignment was significantly more common in type V OI (86%) compared to other types (0%-29%).
- Associated factors included capitellum/radial head/neck dysplasia (except type V capitellum), interosseous membrane calcification (type V specific), and radial/ulnar bowing, correlating with reduced function.
Conclusions:
- Radial head malalignment is a frequent complication of osteogenesis imperfecta, especially type V.
- Malalignment is associated with limb bowing and impaired upper limb function.
- Findings support considering surgical correction for radial and ulnar bowing in select osteogenesis imperfecta patients.
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