Outcomes of Operative Treatment of Forearm Deformity in Children with Osteogenesis Imperfecta: 18 Cases

Osteogenesis imperfecta (OI) often results in recurrent fractures and/or progressive bowing of the long bones, including the arms. Upper extremity deformity has been shown to negatively impact function. The objective of this retrospective case series is to assess the ability to correct deformity, improve function and evaluate the complications and revision rates in our patients with OI who have undergone forearm deformity correction. A retrospective study, approved by The University of Nebraska Medical Center Institutional Review Board, was conducted with OI patients who underwent forearm osteotomy and fixation of one or both forearm bones between December 2011 and August 2018. There were no exclusion criteria. The electronic medical records were reviewed for patient demographics, surgical details, revisions and complications. A total of 48 procedures on 27 forearms in 18 patients were performed during the study. Surgery was performed in children with forearm deformity and recurrent fractures that were interfering with function. Half of the patients had surgery on one forearm and half had surgery on both forearms. The majority of the patients have Type III OI. There were multiple complications, the most common being wire migration which required either replacement or advancement of the wire. In conclusion, forearm deformity in OI is possible, with good healing of osteotomies and fractures, although many patients may require multiple surgical interventions.