{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:15:56Z","timestamp":1784646956085,"version":"3.55.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Osteogenesis imperfecta, commonly referred to as brittle bone disease, is the most prevalent monogenic bone disorder and is characterized by osteoporosis and heightened bone fragility. Most patients experience multiple fractures, some of which can be managed conservatively; however, patients with numerous fractures frequently develop significant limb deformities and growth abnormalities that require surgical intervention. For adult patients, intramedullary fixation of osteotomies is typically the preferred option; however, this approach is less suitable for children due to their ongoing growth and development, which necessitates periodic replacement of intramedullary nails and thus repeated surgeries. Moreover, increased bone fragility and a high propensity for fractures in children with osteogenesis imperfecta contribute to frequent postoperative complications, such as refractures and displacement of internal fixation. To address these challenges, extendable intramedullary nails have been developed. In this context, we used these nails to treat a pediatric patient with multiple femoral fractures and severe deformity, with favorable clinical outcomes during a 2-year postoperative follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case report<\/jats:title>\n                    <jats:p>We present the case of a 12-year-old female patient with postnatally diagnosed osteogenesis imperfecta who sustained multiple fractures over time, the most severe being bilateral femoral fractures. She was admitted to our facility on two occasions for femoral shaft fractures. We employed osteotomy, orthopedic techniques, and extendable intramedullary nailing for her treatment. Postoperatively, she showed satisfactory recovery from bilateral femoral deformities, with successful fracture healing and near-normal lower limb lengths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Extendable intramedullary nailing exhibits favorable clinical efficacy in the management of fracture-related deformities in pediatric patients with osteogenesis imperfecta, offering novel insights and options for clinical diagnosis and treatment, thereby demonstrating significant clinical utility.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2025.1454192","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:30:06Z","timestamp":1768285806000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Extendable intramedullary nailing in a child with osteogenesis imperfecta of bilateral femoral fractures: a case report"],"prefix":"10.3389","volume":"12","author":[{"given":"Weishuai","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuchao","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nannan","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianyou","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haotian","family":"Hu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"464","DOI":"10.3390\/medicina57050464","article-title":"Current overview of osteogenesis imperfecta","volume":"57","author":"Deguchi","year":"2021","journal-title":"Medicina (B Aires)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1016\/S0140-6736(15)00728-X","article-title":"Osteogenesis imperfecta","volume":"387","author":"Forlino","year":"2016","journal-title":"Lancet"},{"key":"B3","doi-asserted-by":"publisher","first-page":"453","DOI":"10.18019\/1028-4427-2021-27-4-453-460","article-title":"Osteogenesis imperfecta: current issues of etiology, pathogenesis, classification (systematic review)","volume":"27","author":"Ryabykh","year":"2021","journal-title":"Genij Ortopedii"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s11914-016-0299-y","article-title":"Advances in the classification and treatment of osteogenesis Imperfecta","volume":"14","author":"Thomas","year":"2016","journal-title":"Curr Osteoporos Rep"},{"key":"B5","doi-asserted-by":"publisher","first-page":"219","DOI":"10.18699\/VJ20.614","article-title":"Modern classification and molecular-genetic aspects of osteogenesis imperfecta","volume":"24","author":"Zaripova","year":"2020","journal-title":"Vavilovskii Z Genet Sel"},{"key":"B6","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s40246-019-0209-3","article-title":"IFITM5 pathogenic variant causes osteogenesis imperfecta V with various phenotype severity in Ukrainian and Vietnamese patients","volume":"13","author":"Zhytnik","year":"2019","journal-title":"Hum Genomics"},{"key":"B7","doi-asserted-by":"publisher","first-page":"722","DOI":"10.3389\/fgene.2019.00722","article-title":"COL1A1\/2 pathogenic variants and phenotype characteristics in Ukrainian osteogenesis imperfecta patients","volume":"10","author":"Zhytnik","year":"2019","journal-title":"Front Genet"},{"key":"B8","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1186\/s40246-017-0115-5","article-title":"Mutational analysis of COL1A1 and COL1A2 genes among Estonian osteogenesis imperfecta patients","volume":"11","author":"Zhytnik","year":"2017","journal-title":"Hum Genomics"},{"key":"B9","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s40246-016-0083-1","article-title":"Mutation analysis of the COL1A1 and COL1A2 genes in Vietnamese patients with osteogenesis imperfecta","volume":"10","author":"Ho Duy","year":"2016","journal-title":"Hum Genomics"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1493","DOI":"10.3390\/biom11101493","article-title":"Osteogenesis imperfecta: current and prospective therapies","volume":"11","author":"Botor","year":"2021","journal-title":"Biomolecules"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1416","DOI":"10.1080\/09638288.2023.2198259","article-title":"Reducing fracture incidence in children with osteogenesis imperfecta: contribution of orthotics to bisphosphonates treatment","volume":"46","author":"Eylon","year":"2024","journal-title":"Disabil Rehabil"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1787","DOI":"10.1210\/clinem\/dgad035","article-title":"Approach to the patient: pharmacological therapies for fracture risk reduction in adults with osteogenesis imperfecta","volume":"108","author":"Liu","year":"2023","journal-title":"J Clin Endocrinol Metab"},{"key":"B13","doi-asserted-by":"publisher","first-page":"115914","DOI":"10.1016\/j.bone.2021.115914","article-title":"Osteogenesis imperfecta in children","volume":"148","author":"Arshad","year":"2021","journal-title":"Bone"},{"key":"B14","doi-asserted-by":"publisher","first-page":"2307","DOI":"10.1210\/clinem\/dgae791","article-title":"Genetics and bone mineral density predict the fractures in adults with osteogenesis Imperfecta: a prospective study","volume":"110","author":"Blandin","year":"2025","journal-title":"J Clin Endocrinol Metab"},{"key":"B15","doi-asserted-by":"publisher","first-page":"597","DOI":"10.1089\/hum.2024.191","article-title":"Comprehensive review of osteogenesis imperfecta: current treatments and future innovations","volume":"36","author":"Chaugule","year":"2025","journal-title":"Hum Gene Ther"},{"key":"B16","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1007\/s11914-021-00665-z","article-title":"Osteogenesis imperfecta\u2014who needs rodding surgery?","volume":"19","author":"Fassier","year":"2021","journal-title":"Curr Osteoporos Rep"},{"key":"B17","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1097\/MOP.0000000000000968","article-title":"Osteogenesis imperfecta: treatment and surgical management","volume":"33","author":"Hidalgo Perea","year":"2021","journal-title":"Curr Opin Pediatr"},{"key":"B18","first-page":"205","article-title":"Surgical treatment in osteogenesis imperfecta\u201410 years experience","volume":"6","author":"Georgescu","year":"2013","journal-title":"J Med Life"},{"key":"B19","doi-asserted-by":"publisher","first-page":"S52","DOI":"10.1016\/j.injury.2019.01.045","article-title":"Elastic intramedullary nailing of the femur fracture in patients affected by osteogenesis imperfecta type 3: indications, limits and pitfalls","volume":"50","author":"Persiani","year":"2019","journal-title":"Injury"},{"key":"B20","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1097\/BPB.0000000000001178","article-title":"A novel sliding double flexible intramedullary nail technique for the management of lower extremity long bone fractures and deformities in osteogenesis imperfecta","volume":"34","author":"Karami","year":"2025","journal-title":"J Pediatr Orthop B"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3390\/children9020268","article-title":"Fractures in osteogenesis imperfecta: pathogenesis, treatment, rehabilitation and prevention","volume":"9","author":"Nijhuis","year":"2022","journal-title":"Children"},{"key":"B22","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1186\/s12891-023-06222-2","article-title":"Which is the best femoral implant in children with osteogenesis imperfecta? A retrospective cohort study of 783 procedures","volume":"24","author":"Yang","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"B23","doi-asserted-by":"publisher","first-page":"1240","DOI":"10.7150\/ijms.53286","article-title":"Incidence and treatment of adult femoral fractures with osteogenesis imperfecta: an analysis of a center of 72 patients in Taiwan","volume":"18","author":"Lee","year":"2021","journal-title":"Int J Med Sci"},{"key":"B24","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1177\/18632521251332498","article-title":"Plates for the treatment of long bone metaphyseal and diaphyseal fracture and deformity in osteogenesis imperfecta: a scoping review","volume":"19","author":"Louni","year":"2025","journal-title":"J Child Orthop"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1645","DOI":"10.1007\/s00264-024-06113-8","article-title":"Surgical treatment of osteogenesis imperfecta: a summary of the incidence of femoral implant-related complications in children with Sillence type I, III and IV","volume":"48","author":"Li","year":"2024","journal-title":"Int Orthop"},{"key":"B26","volume-title":"Stress Reaction and Fractures","author":"Kiel","year":"2024"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1007\/s00264-023-05818-6","article-title":"Bone allografting: an original method for biological osteosynthesis and bone reinforcement in children with osteogenesis imperfecta","volume":"47","author":"Gaume","year":"2023","journal-title":"Int Orthop"},{"key":"B28","doi-asserted-by":"publisher","first-page":"71","DOI":"10.13107\/jocr.2250-0685.812","article-title":"The reversed less invasive stabilisation system-distal femur technique: application in an adult patient with osteogenesis Imperfecta sustaining a femoral fracture","volume":"7","author":"Hanke","year":"2017","journal-title":"J Orthop Case Rep"},{"key":"B29","doi-asserted-by":"publisher","first-page":"171","DOI":"10.1097\/00003086-198109000-00023","article-title":"Further clinical experience with the extensible nail","volume":"159","author":"Bailey","year":"1981","journal-title":"Clin Orthop Relat Res"},{"key":"B30","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1097\/BPO.0000000000000285","article-title":"Intramedullary fixation using Kirschner wires in children with osteogenesis imperfecta","volume":"35","author":"Imajima","year":"2015","journal-title":"J Pediatr Orthop"},{"key":"B31","doi-asserted-by":"publisher","first-page":"422","DOI":"10.1302\/0301-620X.71B3.2656718","article-title":"The role of expanding intramedullary rods in osteogenesis imperfecta","author":"Stockley","year":"1989","journal-title":"J Bone Joint Surg Br"},{"key":"B32","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1302\/1863-2548.12.170009","article-title":"Effects of a telescopic intramedullary rod for treating patients with osteogenesis imperfecta of the femur","volume":"12","author":"Rosemberg","year":"2018","journal-title":"J Child Orthop"},{"key":"B33","doi-asserted-by":"publisher","first-page":"e301","DOI":"10.1097\/BPO.0000000000002040","article-title":"Complications of elongating intramedullary rods in the treatment of lower extremity fractures for osteogenesis imperfecta: a meta-analysis of 594 patients in 40 years","volume":"42","author":"Yong","year":"2022","journal-title":"J Pediatr Orthop"},{"key":"B34","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1097\/BPO.0000000000002810","article-title":"Long-term outcomes of intramedullary nails in osteogenesis imperfecta: fewer surgeries and longer survival times with telescoping rods in patients with over ten years follow-up","volume":"45","author":"Nguyen","year":"2025","journal-title":"J Pediatr Orthop"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.3390\/jpm12071151","article-title":"Surgical strategy to decrease the revision rate of Fassier-Duval nailing in the lower limbs of osteogenesis imperfecta","volume":"12","author":"Hung","year":"2022","journal-title":"J Pers Med"},{"key":"B36","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1186\/s13018-023-03917-z","article-title":"Fixation techniques in lower extremity correction osteotomies and fractures in mild-to-severe osteogenesis imperfecta patients: evaluation of the results and complications","volume":"18","author":"Emet","year":"2023","journal-title":"J Orthop Surg Res"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1454192\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T06:30:08Z","timestamp":1768285808000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1454192\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,13]]},"references-count":36,"alternative-id":["10.3389\/fsurg.2025.1454192"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1454192","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,13]]},"article-number":"1454192"}}