To assess the relationship between osteogenesis imperfecta (OI) and metaphyseal fractures in infants and young children under 2 years old.
Key Findings:
Only one radiograph met consensus criteria for a classic metaphyseal fracture.
Definitions of 'metaphyseal fracture' varied across studies.
Some cases lacked genetic confirmation of OI.
Image quality was often insufficient for confident interpretation.
No classic metaphyseal fractures were identified in over 500 children with OI by the senior author.
The mean age of patients was 8.6 months.
Interpretation:
The evidence linking OI to classic metaphyseal fractures is limited and inconclusive, necessitating thorough investigation of such fractures for potential inflicted injury, highlighting the need for careful assessment in clinical practice.
Limitations:
Only four studies were included, most of low or intermediate quality.
Published radiographs were frequently nondiagnostic.
Original imaging files were unavailable.
Heterogeneity across reports prevented pooled analysis.
The review screened 298 abstracts, indicating a limited evidence base.
Conclusion:
Classic metaphyseal fractures in infants and young children should be investigated for possible inflicted injury, even with confirmed OI.
