Plates for the treatment of long bone metaphyseal and diaphyseal fracture and deformity in osteogenesis imperfecta: A scoping review.

PURPOSE

Osteogenesis imperfecta is a rare disorder characterized by bone fragility. The current gold standard treatment for long bone fractures and deformities is telescopic intramedullary rods. Although the use of plates as a standalone implant has been discouraged, recent research has investigated their use as an adjunct to intramedullary fixation. This scoping review aims to assess the current literature on plates for the treatment of long bone metaphyseal and diaphyseal fractures and deformities in osteogenesis imperfecta.

METHODS

The MEDLINE, Embase, CENTRAL, and CDSR databases were searched via PubMed, Ovid, and Cochrane. Titles and abstracts of studies were screened, followed by full assessment of selected articles. Studies included were peer-reviewed, published in English in the last 20 years, and investigated plating alone or combined with other implants for the treatment of metaphyseal or diaphyseal long bone fractures and deformities in osteogenesis imperfecta.

RESULTS

Eleven articles were included: four investigated plating alone, two compared different implants, and five assessed plating as an adjunct to intramedullary fixation.

CONCLUSIONS

Using plates alone is not recommended due to the high rate of complications, implant-related complications, and revision surgeries. However, they can be used when deemed appropriate by the surgeon or in narrow canals. Overall, the use of plates as an adjunct to intramedullary nails shows promising results, although further research is required to determine the indications for additional plating and the best timing of plate removal.

LEVEL OF EVIDENCE

Level III (scoping review).