# Surgical Management of a Proximal Tibial Epiphyseal Fracture in a Pediatric Patient with Osteogenesis Imperfecta

## TL;DR

This paper describes a successful surgical treatment of a rare tibial fracture in a teenager with brittle bone disease.

## Contribution

The study presents a novel surgical approach tailored for bone fragility in osteogenesis imperfecta.

## Key findings

- A displaced tibial tuberosity fracture in a patient with OI was successfully managed with customized surgical techniques.
- Open reduction and internal fixation using lag screws proved effective for stable healing in fragile bone.
- Multidisciplinary follow-up ensured favorable postoperative recovery and minimized complications.

## Abstract

Osteogenesis imperfecta (OI) is a heritable connective tissue disorder characterized by defective type I collagen synthesis, leading to reduced bone strength and increased susceptibility to fractures, often with minimal trauma. Fractures involving the tibial tuberosity are rare and typically occur in adolescents during periods of rapid growth, usually following high-demand activities. We report a case of a 14-year-old male with type I OI who sustained a displaced tibial tuberosity avulsion fracture with epiphyseal and intra-articular extension (Salter-Harris type III, Ogden type IIIA) following low-energy trauma. Surgical management was undertaken via open reduction and internal fixation using partially threaded lag screws through a medial parapatellar approach, with precautions tailored to the patient’s underlying bone fragility. Postoperative recovery was favorable, and the patient remained under multidisciplinary follow-up. This case emphasizes the importance of individualized surgical planning and technique in patients with OI to ensure stable fixation and minimize complications associated with bone fragility.