Femur Fracture Caused by Falling of a Boy with Osteogenesis Imperfecta

Hiro Matsukura^1, and Yuto Takashima²

¹Departments of Pediatrics, Saiseikai Toyama Hospital, 33-1 Kusunoki Toyama, 931-8533, Japan

²Departments of Orthopedics, Saiseikai Toyama Hospital, 33-1 Kusunoki Toyama, 931-8533, Japan

Cite this paper

Hiro Matsukura and Yuto Takashima. Femur Fracture Caused by Falling of a Boy with Osteogenesis Imperfecta. American Journal of Medical Case Reports. 2020; 8(4):98-99. doi: 10.12691/AJMCR-8-4-1

Abstract

Osteogenesis imperfecta (OI) is the most common hereditable cause of bone fragility in children. A Japanese 2-year-old boy fell accidentally from a slide, sustaining a femur shaft fracture. Several maternal family members had experienced episodes of hearing impairment and bone fracture. The injury mechanism was clear and competent. Child abuse was unlikely. Strong family history and presence of blue sclera confirmed the OI diagnosis. Any doctor treating pediatric femur fractures should recall the rare cause of OI. Clinical evaluation alone without a family interview might not complete the diagnosis with OI. We continued proposing to his parents the benefit of receiving bisphosphonate treatment.

Keywords

blue sclera, bone fragility, hearing loss, non-accidental injury, spica cast

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Byers PH, Krakow D, Nunes ME, Pepin M. Genetic evaluation of suspected osteogenesis imperfecta (OI). Genet Med 2006; 8(6): 383-8.
[2]	Ren J, Xu X, Jian X, Wang J. Osteogenesis imperfecta type I: A case report. Exp Ther Med 2014; 7: 1535-8.
[3]	Fritz JM, Guan Y, Wang M, Smith PA, Harris GF. A fracture risk assessment model of the femur in children with osteogenesis imperfecta (OI) during gait. Med Eng Phys 2009; 31(9): 1043-8.
[4]	Meredith Z. Osteogenesis Imperfecta: Differentiating clinical presentation from non-accidental injury. JBJS JOPA 2019; 7(3): p e0001.
[5]	Capra L, Levin AV, Howard A, Shouldice M. Characteristics of femur fractures in ambulatory young children. Emerg Med J 2013; 30(9): 749-53.
[6]	Hoytema van Konijnenburg EM, Vrolijk-Bosschaart TF, Bakx R, Van Rijn RR. Paediatric femur fractures at the emergency department: accidental or not? Br J Radiol 2016; 89(1061): 20150822.
[7]	Pepin MG, Byers PH. What every clinical geneticist should know about testing for osteogenesis imperfecta in suspected child abuse cases. Am J Med Genet C Semin Med Genet 2015; 169(4): 307-13.
[8]	Wanna SBC, Basaruddin KS, Mat Som MH, Sulaiman AR, Shukrimi A, Khan SF, Majid MSA, Ridzuan MJM. Fracture risk prediction on children with Osteogenesis Imperfecta subjected to loads under activity of daily living. IOP Conf. Ser.: Mater. Sci. Eng. 2018; 429: 012004.
[9]	Guttmacher AE, Collins FS, Carmona RH. The family history-more important than ever. N Engl J Med 2004; 351(22): 2333-6.
[10]	Tournis S, Dede AD. Osteogenesis imperfecta - A clinical update. Metabolism 2018; 80: 27-37.