Using humeral nail for surgical reconstruction of femur in adolescents with osteogenesis imperfecta

Figure 1 Clinical presentation of case 1. A 12-year-old girl with type I osteogenesis imperfecta presented with progressive bowing of left shaft femur after ender nail fixation for 3 years. Plain radiographs of left femur in anteroposterior and lateral views on preoperative period (A), immediately after multi-level osteotomy and internal fixation with humeral nail (B), 9-mo after humeral nail fixation (C), preoperative scanogram (D) compared with 1-year postoperative scanogram (E).

Figure 2 Clinical presentation of case 2. A 12-year-old girl with type III osteogenesis imperfecta presented with limping and pain on full weight bearing after Rush pin fixation for 4 years. Plain radiographs in anteroposterior and lateral views after injury (A), immediately after Rush pin fixation (B), 4 years after Rush pin fixation (C), immediately after humeral nail fixation (D), 9 mo after humeral nail fixation (E), and 1-year postoperative scanogram after humeral nail fixation (F).

Figure 3 Clinical presentation of case 3 during the first operation. A 16-year-old male with type III osteogenesis imperfecta presented with subtrochanteric peri-implant fracture of left femur after corrective osteotomy and fixation with osteotomy plate for 10 mo. Plain radiographs in anteroposterior and lateral views after injury (A), immediately after humeral nail fixation (B), and 8 mo after humeral nail fixation (C).

Figure 4 Clinical presentation of case 3 during the second operation. A 16-year-old male with type III osteogenesis imperfecta presented with progressive deformity of left distal femur after first humeral nail fixation for 10 mo. Plain radiographs in anteroposterior and lateral views on preoperative period (A), immediately after corrective osteotomy with humeral nail fixation (B), and 9 mo after humeral nail fixation (C).

Figure 5 Clinical presentation of case 3 during the third operation. A 17-year-old male with type III osteogenesis imperfecta presented with progressive deformity after Rush pin fixation right shaft femur at early childhood. Plain radiographs in anteroposterior and lateral views on preoperative period (A), immediately after corrective osteotomy with humeral nail fixation (B), and 6 mo after humeral nail fixation (C).