Is There an Increased Risk of Metaphyseal Fractures in Infants with Osteogenesis Imperfecta? A Systematic Review
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By
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Ella Riley
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Michael Paddock
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Sara Elgarwany
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Joanna Fairhurst
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Kath Halliday
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Annmarie Jeanes
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Karl Johnson
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Amaka C Offiah
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April 8, 2026
Clinical Scorecard: Is There an Increased Risk of Metaphyseal Fractures in Infants with Osteogenesis Imperfecta? A Systematic Review
At a Glance
| Category | Detail |
|---|
| Condition | Osteogenesis Imperfecta (OI) |
| Key Mechanisms | Inherited disorder of connective tissue leading to fragile bones and fractures. |
| Target Population | Infants and young children with OI less than 2 years of age. |
| Care Setting | Pediatric medical and surgical settings. |
Key Highlights
- Limited evidence suggests OI may not predispose infants to metaphyseal fractures.
- Metaphyseal fractures are highly specific for physical abuse.
- Physical abuse should be considered in infants with metaphyseal fractures, even with confirmed OI.
- The study included only four articles on the topic, indicating a need for more robust research.
Guideline-Based Recommendations
Diagnosis
- Thorough investigation for inflicted injury in infants with metaphyseal fractures.
Management
- Multidisciplinary team input is essential for managing patients with OI.
Monitoring & Follow-up
- Regular assessment of fracture prevalence in infants with OI.
Risks
- Misdiagnosis of fractures due to the overlap of OI and physical abuse.
Patient & Prescribing Data
Infants and young children diagnosed with OI.
Bisphosphonate therapy is the cornerstone of medical management for improving bone fragility.
Clinical Best Practices
- Differentiate between classic metaphyseal lesions and other types of fractures.
- Utilize expert radiological assessment in cases of suspected child abuse.
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