Stress Shielding in the Setting of Osteogenesis Imperfecta and the Effect of Downsizing an Intramedullary Rod: A Case Report

JBJS Case Connect. 2021 Jul 23;11(3). doi: 10.2106/JBJS.CC.20.00680.

Abstract

Case: Cortical atrophy, or stress shielding, secondary to a large-diameter femoral intramedullary rod was noted over almost a decade in a now 14-year-old girl with osteogenesis imperfecta (OI). After an initial minimally invasive unsuccessful revision, we downsized the left femur rod with realignment and noted restoration of the left femur cortical thickness.

Conclusion: We demonstrate the significant functional impact of stress shielding and its evolution over a protracted period and outline treatment principles. To our knowledge, this is the first report of treatment of stress shielding of a long bone in the setting of OI.

Publication types

  • Case Reports
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Female
  • Femoral Artery
  • Femur
  • Humans
  • Internal Fixators
  • Lower Extremity
  • Osteogenesis Imperfecta* / complications
  • Osteogenesis Imperfecta* / surgery