WOFAPS 2025 8th World Congress of Pediatric Surgery

Yangyang Yao, Yanzhou Wang, Tianyou Li, Jiaqi Wang, Xiaoqing Wang

Shandong Provincial Hospital, Jinan, Shandong, China

Purpose: Fractures or deformities in osteogenesis imperfecta (OI) predominantly affect the lower extremities, and there have been extensive reports on surgical treatment methods and outcomes. However, there is scant literature regarding fractures or deformities involving the upper extremities, particularly the forearm. This study presents our experience with surgical management of forearm fractures or deformities in OI.

Method: This study retrospectively analyzed the clinical data of OI patients who underwent surgical treatment for forearm fractures or deformities at our hospital. They received open reduction or osteotomy, and internal fixation for ulnar and radial fractures or deformities. Postoperative follow-ups were conducted regularly to assess recovery. Detailed records included patient demographics, surgical information, fracture healing time, postoperative functional recovery, and complications.

Results: Five male OI patients (seven forearms) were included. Three patients were treated for fractures, and two patients underwent corrective osteotomy for deformities. The mean age was 15.43 ± 7.31 years (range: 5–25), with an average follow-up duration of 26.14 ± 31.25 months (range: 3–97). All patients underwent plaster immobilization for six weeks, followed by functional exercises. By three months post-surgery, all patients had resumed daily activities without significant functional limitations. Two patients experienced implant migration leading to wound dehiscence: one healed with wound dressing changes and tolerated irritation from the internal fixation, while the other required implant removal. No perioperative complications were observed.

Conclusion: For patients with OI complicated by forearm fractures or deformities, surgical intervention can yield favorable outcomes despite significant surgical risks and a high incidence of implant migration. Particularly in patients with function-impairing forearm deformities, realignment through forearm bone osteotomy can significantly improve functional outcomes. Therefore, surgical indications should be rigorously evaluated. For patients requiring intervention, surgical management of forearm fractures or deformities in OI is challenging but worthwhile due to functional improvement.