Using humeral nail for surgical reconstruction of femur in adolescents with osteogenesis imperfecta

Long-term follow-up of a cat with an undetermined osteoporotic bone disease managed with multiple intramedullary pins

Case summary

Osteogenesis imperfecta (OI) is an inherited disorder related to the synthesis of type 1 collagen. Clinical signs of pain from the fracture of fragile bones are common. A 3-month-old male Chinchilla cat was presented for lameness and pain from a right femoral fracture. After surgical repair using intramedullary pins, and since repeated fractures occurred and there is little information about genes causing OI in cats, various examinations were performed to discriminate other diseases that could cause the pathological fracture. Primary hyperparathyroidism and nutritional or renal secondary hyperparathyroidism were ruled out through blood tests and ultrasonography. Quantitative CT confirmed low trabecular bone mineral density compared with normal cats. Radiography and histopathological examination revealed thin cortical bone. OI was tentatively diagnosed and long-term follow-up of the surgical repair was reviewed. Fractures were treated using intramedullary Kirschner wires. The same method of intramedullary pinning was then applied preventively to protect several other long bones by improving stress distribution and bending resistance. Follow-up was performed for 3 years until the patient’s death due to undetermined reasons.

Relevance and novel information

Although the patient underwent repeated fractures and bone unions, and needed medication for pain management sometimes, it was generally able to live as a companion cat. Therefore, palliative preventive intramedullary pinning could be used for long-term management of patients suspected of OI.

Surgical Treatment of Bilateral Tibia Deformity in a 9-Year-Old Child Suffering from Osteogenesis Imperfecta Type III: A Case Report

Patient: Male, 9

Final Diagnosis: Osteogenesis imperfecta type III

Symptoms: Walking difficulties

Medication: —

Clinical Procedure: Osteotomies and realignment of bone deformity

Specialty: Orthopedics and Traumatology