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In-toeing in children with type I osteogenesis imperfecta: an observational descriptive study
Marta Elena Losa Iglesias1, Ricardo Becerro de Bengoa Vallejo, Paloma Salvadores Fuentes
1Department of Health Sciences II-Facultad de CC de la Salud, Universidad Rey Juan Carlos, Madrid, Spain. marta.losa@urjc.es
Insights
Children with osteogenesis imperfecta (brittle bone disease) often have undiagnosed in-toeing gait due to torsional deformities or metatarsus adductus. Early detection and management of this gait abnormality are crucial for preventing fractures.
Area of Science:
- Pediatric Orthopedics
- Genetics
- Biomechanical Analysis
Background:
- Osteogenesis imperfecta (OI), or brittle bone disease, is an inherited connective tissue disorder causing bone fragility.
- Patients with OI are highly susceptible to fractures from minor trauma, necessitating fall risk reduction strategies.
- In-toeing gait in children, often caused by torsional issues or metatarsus adductus, can lead to tripping and functional impairments.
Purpose of the Study:
- To investigate the prevalence of in-toeing gait in children with Type I Osteogenesis Imperfecta.
- To identify if in-toeing is linked to tibial or femoral torsion, or metatarsus adductus in this population.
- To assess the potential for undiagnosed gait abnormalities contributing to fall risk in OI patients.
Main Methods:
- A descriptive study involving orthopedic and biomechanical assessments.
- Evaluated 15 children (ages 4-9) diagnosed with Type I Osteogenesis Imperfecta.
- Excluded patients using mobility aids like wheelchairs, crutches, or canes.
Main Results:
- A high prevalence of 80% (12 out of 15 children) showed undiagnosed in-toeing gait.
- The in-toeing was attributed to torsional deformities or metatarsus adductus in all but one participant.
- This suggests a significant association between OI and specific gait abnormalities.
Conclusions:
- In-toeing gait, stemming from torsional deformity or metatarsus adductus, is common in children with Osteogenesis Imperfecta.
- Identifying and managing in-toeing gait is vital for preventing fractures associated with falls in these patients.
- Routine gait screening may be beneficial for children diagnosed with OI.
Background:
Osteogenesis imperfecta is an autosomal-dominant disorder of the connective tissue. Also known as brittle bone disease, it renders those affected susceptible to fractures after minimal trauma. Therefore, it is important to minimize the risk of falls and subsequent fractures in patients with this disease. In-toeing is a common condition in children that can result from various pathologic entities, including anteversion, internal tibial torsion, and metatarsus adductus. These conditions can result in frequent tripping and other functional problems.
Methods:
A descriptive study was undertaken to determine the prevalence of in-toeing gait attributable to tibial or femoral torsion or metatarsus adductus in children with type I osteogenesis imperfecta. The study involved orthopedic and biomechanical examination of 15 children (9 girls and 6 boys) aged 4 to 9 years with confirmed type I osteogenesis imperfecta. Patients who used assistive ambulatory devices, such as canes, crutches, and wheelchairs, were excluded from the study.
Results:
Of the 15 children studied, 12 (80%) demonstrated previously undiagnosed in-toeing gait attributable to torsional deformity or metatarsus adductus in all but one child.
Conclusions:
Many children with confirmed type I osteogenesis imperfecta have in-toeing gait caused by torsional deformity or metatarsus adductus. Detection and control of in-toeing gait in children with osteogenesis imperfecta is important to prevent fractures resulting from trauma directly related to these conditions.
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