Conservative versus surgical treatment of osteogenesis imperfecta: A retrospective analysis of 29 patients

Eugenio Chiarello, Davide Donati, Giuseppe Tedesco, Luca Cevolani, Tommaso Frisoni, Matteo Cadossi, Martha Hoque, Benedetta Spazzoli, Sandro Giannini

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Abstract

The aim of our study was to compare the surgical and conservative treatment of patients affected by fragility fractures and deformities of long bones in osteogenesis imperfecta (OI). Our series consisted of 29 consecutive OI patients treated at our Institute. The series comprised 14 females and 15 males of different ages. The mean age at the time of the first treatment was 8 years (median 6 years; SD ± 15; range 1 to 75). The mean follow-up was 88 months. The Sillence classification was used to classify OI. Fifteen patients were classified as Type I; five as Type III and nine as Type IV. A total number of 245 procedures were recorded. Of these, 147 were surgical (pinning; intramedullary nailing and plating) while 98 were conservative (cast, braces and bandages). Bisphosphonate use was a major variable in the study. Clinical charts and radiographic films were analyzed for complications (delayed union, nonunion, malunion, hardware loosening). We recorded 58 complications: 13 in Type I; 28 in Type III and 17 in Type IV OI. The rate of each complication was: 15/245 nonunions (6.1%), 14/245 delayed unions (5.7%), 14/245 malunions (5.7%) and 15/245 hardware loosenings (6.1%). We found no statistically significant differences between surgical and conservative treatments. Type III OI, which is a very crippling form of the disease, was associated with radiographically poorer results than the other types. In our analysis, the two groups were unbalanced and only five patients were treated with bisphosphonates. Nevertheless, bisphosphonate use can be considered a good adjuvant to both the conservative and surgical treatment of OI in order to reduce the rate of complications.

Original languageEnglish
Pages (from-to)191-194
Number of pages4
JournalClinical Cases in Mineral and Bone Metabolism
Volume9
Issue number3
Publication statusPublished - Sep 2012

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Keywords

  • Bisphosphonates
  • Complications
  • Conservative treatment
  • Osteogenesis imperfecta
  • Surgical treatment

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine

Cite this

Chiarello, E., Donati, D., Tedesco, G., Cevolani, L., Frisoni, T., Cadossi, M., Hoque, M., Spazzoli, B., & Giannini, S. (2012). Conservative versus surgical treatment of osteogenesis imperfecta: A retrospective analysis of 29 patients. Clinical Cases in Mineral and Bone Metabolism, 9(3), 191-194.