To ascertain the prevalence of metaphyseal fractures in children with osteogenesis imperfecta (OI) less than 2 years of age.
Approach:
Search Strategy: Medline, CINAHL, and Web of Science were searched for studies reporting metaphyseal fractures in children with OI under 2 years. Exclusions included non-retrievable articles, non-English publications, and those without defined metaphyseal fractures.
Quality Assessment: Article quality was assessed using the Critical Appraisal Skills Programme and Case Reports tools.
Key Findings:
Only four articles met the inclusion criteria for the review.
Among 41 children with OI, 4 had metaphyseal fractures.
Cases included a 16-month-old boy with three fractures and a 7-month-old girl with two suspected abuse-related fractures.
A pair of siblings with type XI OI also had metaphyseal fractures.
Interpretation:
The association between OI and metaphyseal fractures is not definitively established.
Limitations:
The evidence is based on a small number of studies with poor quality.
Further large studies are needed to clarify the relationship between OI and metaphyseal fractures.
Conclusion:
Physical abuse should always be considered in infants and young children with metaphyseal fractures, even in those with confirmed OI.
