Eylon S, Kornitzer E, Wever C, Rigbi A, Weiss P L, Meyer S
ALYN Pediatric and Adolescent Rehabilitation Center, Jerusalem, Israel.
Beit Berl College, Faculty of Education, Kfar-Saba, Israel.
Disabil Rehabil. 2024 Apr;46(7):1416-1421. doi: 10.1080/09638288.2023.2198259. Epub 2023 Apr 17.
To determine whether there was a reduction in fracture incidence amongst children with OI who were treated with both bisphosphonates and orthoses.
Was there an additional reduction in fracture incidence amongst children with Osteogenesis Imperfecta (OI) treated with both bisphosphonates and Hip-Knee-Ankle-Foot-Orthosis (HKAFO)?
Of the 129 OI patients treated from 1990 to 2017, retrospective data from 48 patients who participated in the bisphosphonates-orthosis regime were analyzed including the incidence of fractures and modalities of fracture treatment.
Bisphosphonates usage was more frequent than bracing and there were more positive changes (smaller or equal number of fractures each year) than negative changes (more fractures each year); negative changes were scarce, explained by non-compliance with the use of bracing. Poisson regression models were significant for positive changes, whereas the interaction between them was borderline significant. The main finding is that the association between bisphosphonates usage and the number of positive changes was stronger among the patients who used braces more frequently and weaker among patients who used bracing less frequently.
Bracing of OI patients has an additive effect on bisphosphonate treatment in fracture prevention which should lead to the reconsideration of a hybrid approach to OI management.
确定接受双膦酸盐和矫形器治疗的成骨不全症（OI）患儿的骨折发生率是否降低。
接受双膦酸盐和髋-膝-踝-足矫形器（HKAFO）治疗的成骨不全症（OI）患儿的骨折发生率是否有额外降低？
对1990年至2017年接受治疗的129例OI患者进行回顾性分析，分析48例参与双膦酸盐-矫形器治疗方案患者的数据，包括骨折发生率和骨折治疗方式。
双膦酸盐的使用比支具更频繁，与骨折数量每年增加（负面变化）相比，骨折数量每年减少或持平（正面变化）的情况更多；负面变化很少，原因是未坚持使用支具。泊松回归模型对正面变化具有显著意义，而两者之间的相互作用接近显著。主要发现是，在更频繁使用支具的患者中，双膦酸盐使用与正面变化数量之间的关联更强，而在较少使用支具的患者中则较弱。
对OI患者使用支具在预防骨折方面对双膦酸盐治疗具有附加作用，这应促使人们重新考虑对OI采用综合治疗方法。
