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The Journal of Bone and Joint Surgery, Vol 70, Issue 3 439-443, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc

JOURNAL CONTENTS

Non-union of fractures in children who have osteogenesis imperfecta

JG Gamble, LA Rinsky, J Strudwick and EE Bleck
Children's Hospital at Stanford, Palo Alto, California 94304.

Although a fracture rarely fails to unite in a healthy child, non-union is not a rare occurrence in a child who has osteogenesis imperfecta. We identified twelve non-unions in ten patients from a population of fifty-two patients who had osteogenesis imperfecta. The average age of these patients when the diagnosis of non-union was made nine years, and the average age at the time of treatment was 12.5 years. All of the patients had had a decrease in functional ability as a result of the non-union. There were five femoral, four humeral, one radial, one ulnar, and one pubic non-union. Five of the non-unions were hypertrophic, and seven were atrophic. Eight of the nine ununited fractures that were operated on healed after excision of the non-union, intramedullary nailing, and bone-grafting. Three of the non-unions (in two patients) were not operated on, and the one patient in whom surgery failed had an amputation. Non-union was frequently associated with repeated fractures at a progressively deforming site.
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