Louni Yacine, Hamdy Reggie
McGill University, Montreal, QC, Canada.
Shriners Hospitals for Children Canada, Montreal, QC, Canada.
J Child Orthop. 2025 Apr 24:18632521251332498. doi: 10.1177/18632521251332498.
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.
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.
Eleven articles were included: four investigated plating alone, two compared different implants, and five assessed plating as an adjunct to intramedullary fixation.
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 III (scoping review).
成骨不全是一种以骨脆性为特征的罕见疾病。目前治疗长骨骨折和畸形的金标准是可伸缩髓内钉。尽管不鼓励单独使用钢板作为植入物，但最近的研究探讨了其作为髓内固定辅助手段的应用。本综述旨在评估目前关于钢板治疗成骨不全患者长骨干骺端和骨干骨折及畸形的文献。
通过PubMed、Ovid和Cochrane检索MEDLINE、Embase、CENTRAL和CDSR数据库。筛选研究的标题和摘要，随后对选定文章进行全面评估。纳入的研究需经过同行评审，在过去20年以英文发表，并研究了单独使用钢板或与其他植入物联合使用治疗成骨不全患者的干骺端或骨干长骨骨折及畸形。
纳入11篇文章：4篇研究单独使用钢板，2篇比较不同植入物，5篇评估钢板作为髓内固定的辅助手段。
由于并发症发生率高、与植入物相关的并发症以及翻修手术，不建议单独使用钢板。然而，在外科医生认为合适时或在狭窄髓腔内可使用钢板。总体而言，钢板作为髓内钉的辅助手段显示出有前景的结果，尽管需要进一步研究以确定额外使用钢板的适应证和最佳取出时机。
三级（综述）。
