Management of a Case of Adult Mid-Shaft Femur Fracture in Osteogenesis Imperfecta by Long Proximal Femoral Nail - A Case report

Sep 29, 2026

Osteogenesis imperfecta (OI) is a rare inherited connective tissue disorder caused by defective type I collagen, predisposing patients to recurrent fractures, deformities, and long-term disability. Intramedullary nailing is described as a gold-standard surgical stabilization for long-bone fractures in OI, offering load sharing, deformity correction, and fracture prevention. The report presents a 34-year-old woman with type IA OI and a spontaneous mid-shaft femur fracture managed with proximal femoral nail fixation, followed by radiographic union and improved function without major complications.

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CategoryHealthcare

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Abstract

Introduction

Case Report

Intervention

Outcome

Conclusion

Keywords

Case Report Journal of Orthopaedic Case Reports 2025 December:15( 12) :Page 163-167 Management of a Case of Adult Mid-Shaft Femur Fracture in Osteogenesis Imperfectaby Long Proximal Femoral Nail: A Case report M B Lingayat¹, Shangreicham Hongvah¹, Arvind Kumar¹, Saurabh Damkondwar ¹, Faiz Ahmad Usmani ¹ Abstract Introduction: Osteogenesis imperfecta (OI) is a rare inherited connective tissue disorder caused by defective type I collagen, which predisposes patients to recurrent fractures, skeletal deformities, and long-term disability. Intramedullary nailing is widely regarded as the gold standard for surgical stabilization of long bone fracturesin OI due to its load-sharing capacity, deformity correction, and ability to prevent future fractures. Case Report: We describe the case ofa 34-year-old female with type IA OI who presented with a spontaneous mid-shaft femur fracture while weight-bearing. She had a history of multiple previous fractures, including bilateral forearm fractures and an atypical femoral fracture, all managed conservatively. Intervention: The patient underwent closed reduction and internal fixation with a proximal femoral nail (PFN). Under fluoroscopic guidance, a long intramedullary nail was inserted, and proximal and distal locking screws were applied to ensure stability. The procedure was performed with minimal soft-tissue disruption. Outcome: Radiographic follow-up demonstrated progressive fracture consolidation at 8 weeks, allowing transition to full weight-bearing by 5 months. The patient regainednearpre-injury functional statuswithout complications such as implant migration, delayed union, orinfection. Conclusion: This case highlights the effectiveness of PFNin managing femoral fracturesin OI patients. PFN provides stable fixation, facilitates early mobilization, and reduces refracture risk. With careful implant selection, surgical planning, and vigilant post-operative monitoring, intramedullary nailing significantly improvesfunctional outcomesand quality of life in OI patients. Keywords: Osteogenesis imperfecta, femur fracture, proximal femoral nail, intramedullary nailing, load-sharing fixation. Introduction Osteogenesis imperfecta (OI) is a rare, inherited connective tissue disorder marked by insufficient or defective type I collagen, leading to recurrent fractures, bone deformities, and chronic disability in affected individuals. Management of OI requires a multidisciplinary approach that includes medical management, physical rehabilitation, and surgical intervention for fracture stabilization and deformity correction. Among |
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DOI:
[https://doi.org/10.13107/jocr.2025.v15.i12.6492](https://doi.org/10.13107/jocr.2025.v15.i12.6492) | Author’s Photo Gallery | | | | | | --- | --- | --- | --- | --- | --- | | | | | |
Dr. Saurabh Damkondwar |
Dr. Faiz Ahmad Usmani | | |
1Department of Orthopedics, Government Medical College, Aurangabad, Maharashtra, India.
Address of Correspondence:
Dr. Shangreicham Hongvah,
Department of Orthopedics, Government Medical College, Aurangabad, Maharashtra, India.
E-mail: [atohongvah@gmail.com](atohongvah@gmail.com) | | | | | | Submitted: 10/09/2025; Review: 12/10/2025; Accepted: November 2025; Published: December 2025 | | | | | | | DOI: [https://doi.org/10.13107/jocr.2025.v15.i12.6492](https://doi.org/10.13107/jocr.2025.v15.i12.6492)
© The Author(s). 2025 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ([https://creativecommons.org/licenses/by-nc/4.0/](https://creativecommons.org/licenses/by-nc/4.0/)), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were ma

FAQs

Why is intramedullary nailing considered a gold standard for OI femur fractures?

Intramedullary nailing provides load-sharing fixation, corrects deformity, and helps prevent future fractures by stabilizing long-bone fractures effectively.

What procedure was performed for the 34-year-old patient in this case report?

The patient underwent closed reduction and internal fixation using a proximal femoral nail, with fluoroscopic guidance and proximal and distal locking screws to ensure stability.

What were the clinical and radiographic outcomes after proximal femoral nail fixation?

Radiographs showed progressive fracture consolidation by 8 weeks, enabling full weight-bearing by 5 months, with near pre-injury functional status and no complications such as implant migration, delayed union, or infection.

Sep 29, 2026

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