Unconventional nailing for tibial reconstruction in adolescent with osteogenesis imperfecta – A rare surgical case report

Ravikumar AS^1*,  Pradeep H²,  Naveen HT²,  Appu G Pillai³

¹Professor, ²Assistant Professor, ³Postgraduate, Department of Orthopaedics
Sri Siddhartha Medical College, SSAHE, Tumkur,
Karnataka, India

* Corresponding author

Abstract
Osteogenesis Imperfecta (OI) is a rare connective tissue disorder known for excessive bone fragility caused by collagen mutations. The common orthopaedic problems related to bone fragility includefrequent multiple bone fractures, progressive deformity of long bones leading to impaired ambulation. Surgical correction of long bone deformities in OI is conventionally done using distraction osteogenesis (Illizarov fixator), elastic intramedullary nailing, rigid extramedullary fixation using plates, after osteotomy. Intramedullary fixation appears to be an ideal choice for correction of recurrent deformity in the long bone and the devices used previously include telescoping rods, single or dual non-elongating nails (rush nail, TENS). Recently reported use of humerus nails for femur reconstruction in 3 adolescent out patients. We report a case of humerus nailing for reconstruction of tibia in an adolescent OI male with excellent outcomes which is first of its kind and not reported previously by any other authors. 
Keywords: Osteogenisis imperfect, Pathological fractures, Intramedullary nail, Deformity correction