Myth About OI
Common Myths about Osteogenesis Imperfecta (OI)
All children with fragile bones have OI
OI is a spectrum of fragile bone disease and all children may not have classical OI but one of the several variants that can cause the bone to be weak. A genetic test can ascertain the type of Fragile Bone Disease
OI only affects the bones
OI affects all collagen tissues, hence children with OI have lax ligaments, loose joints and can also have hearing and dental problmes.
Plaster treatment is better than surgery !
Whilst the initial treatment of fracture is some sort of immobilization, the plaster cast is not a definitive treatment. It can be used for small children (more than 2 years), and while waiting for surgery
Why the plaster is not recommended for treatment of Repeat Fractures?
Plaster casts are heavier and causes osteoporosis of the already weak bone. In a fracture situation, the muscle forces causes deformation of the bone and the malunion leads to the typical bowing deformity seen in OI children.
Why is surgery required for OI long bones?
The main aim of surgery is to prevent re-fractures and further osteoporosis of the weak bone.
The vicious cycle of...
Fracture - Plaster - Osteoporosis - Deformity of bone - Repeat Fracture
Can be broken by inserting a rod...
Surgery for OI bones must be done at skeletal maturity
The biggest myth and incorrect piece of advice given to parents is that
“No Surgery” is required until child is 15 years old.
This condemns the child to childhood disability, poor muscle strength and stress of repeated fractures
Child is too small for surgery
Surgery is usually done for child more than age 2 years of when a walking child presents with fractures. The aim of early rodding is to prevent the next fracture and the immobilization which increases the osteoporosis of the bone
Prolonged immobilization is required after surgery
The child is kept in light weight plaster or splints for about 3 – 4 weeks and encouraged to weight bear and commence physiotherapy once the fracture healing is seen.
Paediatric Fracture Management" Synopsis of Children Fracture Management & Orthopaedic Management of Duchenne Muscular Dystrophy: A guide for parents and caregivers...