Upper limb surgery in osteogenesis imperfecta (OI) has received greater attention after the benefits of stabilising fractured and realigning deformed bones have become more and more known. Surgical interventions for fractured forearms and humeri are indicated, if the displacement of the actual fracture, the number of previous fractures, or the severity of the disease makes internal stabilisation beneficial to the patients in terms of expecting new incidents or increasing deformity and functional impairment. The implants of choice are intramedullary devices such as k-wires, flexible intramedullary nails, or telescopic nails. Fractures which are adjacent to joints or involve the articular surface are treated according to the general rules of paediatric fracture treatment.
Surgical deformity correction is recommended when the extent of functional disability interferes significantly with comfortably carrying out the activities of daily life or threatens independent mobility. Generally, realignment osteotomies of the humerus or forearm are being performed at the apices of the deformed bones and fixed with either telescoping intramedullary nails or intramedullary K-wires. In many patients, humerus and forearm correction are requested from the patient.
Due to the bone sizes and the partly bizarre deformities, these surgical interventions are very demanding procedures. They can only be indicated for patients with bones of appropriate sizes and in older ages compared to corrective surgeries of the lower extremity.
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