Unique Considerations of the Adult with Osteogenesis Imperfecta

The treatment of the adult with osteogenesis imperfecta begins with the vulnerable transition phase from childhood to adulthood and also after trauma or injury. Rehabilitation physicians and therapists play a decisive role in planning and executing care and prescribing therapeutic exercise. Optimal medical treatment may include dietary calcium, vitamin D, bisphosphonates and anabolic agents to optimize bone quality. Fracture management focuses on lightweight splints and early return to function when possible. Unique surgical concerns in the adult include the needs to assess comorbidities, propensity to non-union, difficulty in achieving limb alignment and degenerative arthritis. Surgical treatment is complicated by the existence of long-standing deformity, and specific achievable goals need to be understood by patient and surgeon.