1. Department of Pediatrics, MacKay Memorial Hospital, Hsinchu, Taiwan.
2. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
3. Department of Orthopedics, MacKay Memorial Hospital, Taipei, Taiwan.
4. Department of Medicine, MacKay Medical College, New Taipei City, Taiwan.
5. Division of Genetics and Metabolism, Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan.
6. College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan.
7. Department of Pediatrics, MacKay Memorial Hospital, Taipei, Taiwan.
8. MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan.
9. Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan.
10. Department of Rare Disease Center, MacKay Memorial Hospital, Taipei, Taiwan.
11. Department of Infant and Child Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Background: Osteogenesis imperfecta (OI) is a rare disease characterized by increased bone fragility and susceptibility for fractures. Only few studies have compared the management for femoral fractures in children with OI. Nevertheless, no cohort studies have described the treatment for femoral fractures in adults with OI in Taiwan. This study aimed to investigate and compare the incidence of union and non-union femoral fractures and the best treatment options to avoid non-union fractures.
Methods: We enrolled 72 patients with OI who were older than 18 years at MacKay Memorial Hospital between January 2010 and December 2018. Femoral fracture incidence, non-union rate, and treatment modality were analyzed.
Results: Of 72 patients with OI, 11 patients had femoral fractures and 4 patients of them had >1 femoral fracture. The incidence for all types of femoral fractures was 651 fractures per 100,000 person-years annually. In 15 total fractures, 4 fractures resulted in non-union, and patients with type 4 OI mostly had shaft fractures. The best outcomes for non-union shaft fracture is achieved by surgical treatment.
Conclusion: Adults with OI tended to develop femoral fractures and non-unions. Adults with type 4 OI were particularly at high risk for non-unions in shaft fractures with conservative treatment.
Keywords: adult, femoral fracture, non-union, osteogenesis imperfect, Taiwan