Scaphoid Reconstruction Following Nonunion in Osteogenesis Imperfecta: A Case Report
Karina A Lenartowicz1,2, Ryan A Paul1,3, Andrew Howard1,2
1Division of Orthopedic Surgery, Affiliated With Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Case:
An 11-year-old boy with osteogenesis imperfecta (OI) type 1 presented with a chronic scaphoid waist nonunion accompanied by cyst formation and dorsal intercalated segment instability. He had a history of treatment with bisphosphonate therapy and discontinued zoledronate 3 months before surgery. He underwent scaphoid reconstruction using nonvascularized, corticocancellous bone graft from the iliac crest and a buried headless compression screw. Within 12 weeks, imaging demonstrated union with bony remodeling and he resumed zoledronate.
Conclusion:
Temporary discontinuation of bisphosphonate therapy may normalize bone healing and reduce the risk of bisphosphonate-related delayed union in scaphoid reconstruction for children with OI.


