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These procedures may also serve the prophylactic
functions of preventing progressive deformities from
worsening and preventing additional injuries by
stabilizing and strengthening limbs.
Common indications for surgical intervention
include correction of limb deformities, stabilization
of chronic non-unions and revision of implant from
previous procedures. The tibia is the most common
cause of deformity in this population.
Osteotomies may be safely and effectively done in
adult patients with OI.
Strut allografts provide stabilization to and promote
healing of osteotomies, fractures and chronic
non-unions within a reasonable timeframe.
In patients with implant that has become prominent
due to IM rod migration or limb shortening, removal
or realignment can help to restore range of motion
and relieve pain and stiffness.
Reconstructive procedures can be performed with
a relatively low rate of complications, and the
main adverse outcomes observed in reconstruction
procedures are the development of prominent
implant and the delayed union of osteotomies, which
can successfully be addressed through the revision of
implant and additional stabilization with implant or
allografts.
[2] Mooreield Jr WG, Miller GR. Aftermath of osteogenesis
imperfecta: the disease in adulthood. J Bone Joint Surg Am
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[3] Wekre LL, Frøslie KF, Haugen L, Falch JA. A population-based
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ties of daily living in adults with osteogenesis imperfecta.
Disabil Rehabil 2010;32(7):579-87.
[4] Soield HA, Millar EA. Fragmentation, realignment, and
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[5] Bailey RW, Dubow HI. Studies of longitudinal bone growth
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[7] McHale KA, Tenuta JJ, Tosi LL, McKay DW. Percutaneous intra-
medullary ixation of long bone deformity in severe osteogen-
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lisation of the lower limb in osteogenesis imperfecta using the
Shefield telescopic intramedullary rod system. J Bone Joint Surg
Br 1998;80-B:999-1004.
[9] Li YH, Chow W, Leong JC. The Soield-Millar operation in
osteogenesis imperfecta. A modiied technique. J Bone Joint
Surg Br 2000;82(1):11-16.
[10]
Saldanha KAN, Saleh M, Bell MJ, Fernandes JA. Limb length-
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[11]
Cho TJ, Choi IH, Chung CY, Yoo WJ, Lee KS, Lee DY.
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References
[1] Ring D, Jupiter JB, Labropoulus PK, Guggenheim JJ, Stanistky
DF, Spencer DM. Treatment of deformity of the lower limb in
adults who have osteogenesis imperfecta. J Bone Joint Surg Am
1996;78:220-5.
[12]
Esposito P, Plotkin H. Surgical treatment of osteogenesis imper-
fecta: current concepts. Curr Opin Pediatr 2008;20(1):52-7.
[13]
Abulsaad M, Abdelrahman A. Modiied Soield-Millar opera-
tion: less invasive surgery of lower limbs in osteogenesis imper-
fecta. Int Orthop 2009;33(2):527-32.
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