Bilateral Distal Humeral Fracture in a patient with Osteogenesis imperfecta During the Covid Pandemic

Bilateral Distal Humeral Fracture in a patient with Osteogenesis imperfecta During the Covid Pandemic– A Rare Case Report

Dr. Vaisakh Reghuram1*, Mr. Milind Mehta2, Mr. Gautam Talawadekar3

1Speciality Doctor T&O, Furness General Hospital , Barrow in Furness, UK.
2Specialist Registrar T&O, Furness General Hospital, Barrow in Furness, .UK
3Consultant T&O, Furness General hospital, Barrow in Furness, UK.

Introduction: Osteogenesis imperfecta (OI) is a genetic disorder which is characterised by bone deformity, low bone mass, connective tissue manifestations and brittle bones with history of multiple fractures. Although recurrent fractures are known in patient with OI, the occurrence of bilateral simultaneous fracture of humerus is quite rare.

Presenting complaint and investigations: The patient had a fall in the outdoors during a storm during the height of covid pandemic and sustained injury to both arms. Radiographs revealed comminuted fracture of left distal humerus and transverse extraarticular supracondylar fracture of right humerus.

Diagnoses, therapeutics interventions, and outcomes: Although, conservative measures were advised as per the guidelines for orthopaedic surgery during the covid pandemic for most of the fractures, the decision to operate was made considering the morbid obesity and hampered mobility due to bilateral above elbow plaster.The patient underwent staged open reduction and internal fixation of both distal humerus with anatomical locking plates in a span of 2 weeks. She recovered uneventfully with a good functional range of movements and resumed her routine activities.

Conclusion: The treatment for complex and unusual fractures should be individualised and should take into consideration of patient’s general condition and safety.

Keywords: osteogenesis imperfecta, brittle bone disease, bilateral, distal humerus fracture

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How to cite this article:

Vaisakh Reghuram, Milind Mehta, Gautam Talawadekar. Bilateral Distal Humeral Fracture in a patient with Osteogenesis imperfecta During the Covid Pandemic– A Rare Case Report. International Journal of Case Reports, 2020; 4:187. DOI: 10.28933/ijcr-2020-11-2205


1. Elmrini A, Boujraf S, Marzouki A et al. Osteo-genesis imperfecta tarda. A case report. Nig J orthop Trauma 2006; 5:61-2
2. Royce PM, Steinmann B, Byers P. Osteogenesis imperfecta. In: Royce PM, Steinmann B, eds. connective tissue and its heritable disorders. Newyork: Wiley-Liss,1993:317-50
3. Byers PH, Wallis GA, Willing MC. Osteogenesis imperfecta: translation of mutation to phenotype. J med Genet 1991; 28:433-42
4. De Paepe A, Nuytinck L, Raes M et al. Homo-zygosity by descent for a COL1A2 mutation in two sibs with severe osteogenesis imperfecta and mild clinical expression in the heterozygotes. Hum Genet 1997; 99:478-83
5. FS Van Dijk and DO Sillence. Osteogenesis im-perfecta: clinical diagnosis, nomenclature and severity assessment. Am J Med Genet A. 2014 Jun; 164(6): 1470–1481.
6. Joseph Maalouly, Dany Aouad, Nabil Dib, Anto-nios Tawk, Georges El Rassi: Simultaneous ORIF for bilateral comminuted proximal humerus frac-tures: Case report in an elderly patient;
7. Thomas P Ruedi, Richard Buckley, Christopher G Moran: AO Principles of Fracture Management; Ann R Coll Surg Engl. 2009 Jul; 91(5): 448–449.
8. Ring D, Jupiter J.B. Fractures of the distal hu-merus.Orthop Clin North Am. 2000; 31: 103-113
9. Riaz A.Agha, Mimi R. Borrelli, Reem Farwana, Kiron Koshy, Alexander J. Fowler, Dennis P. Orgill: The SCARE 2018 statement: Updating consen-sus Surgical Case Report (SCARE) guidelines;
10. Aline Bregou Bourgeois, Bérengère Aubry-Rozier, Luisa Bonafé, Lee Laurent-Applegate, Dominique P Pioletti, Pierre-Yves Zambelli: Osteogenesis imperfecta: from diagnosis and multidisciplinary treatment to future perspectives; Swiss Med Wkly eCollection 2016 Jun 20; 146: w14322.
11. Bonafé L, et al. Nosology and Classification of Genetic Skeletal disorders: 2015 Revision. Am J Med Genet A. 2015;167A (12):2869-92 9999 A:1–24).
12. Heike Hoyer-Kuhn, Christian Netzer & Oliver Semler: Wiener Medizinische Wochenschrift volume 165, pages278–284(2015)
13. Bayram S, Mert L, Anarat FB, Chodza M, Ergin ÖN: A Newborn with Multiple Fractures in Oste-ogenesis Imperfecta: A Case Report.; J Orthop Case Rep. 2018 May-Jun;8(3):71-73
14. Sułko J, Radło W: Operative management of long-bone of the upper limb in children with os-teogenesis imperfecta].; Chir Narzadow Ruchu Ortop Pol. 2005;70(3):195-9.
15. Claro R, Sousa R, Massada M, Ramos J, M Lourenço J: Bilateral posterior fracture-dislocation of the shoulder: Report of two cases. Int J Shoulder Surg. 2009 Apr; 3(2):41-5.
16. Vijay Kumar Jain, Hitesh Lal, Mohit Kumar Pa-tralekh, Raju Vaishya: Fracture management during COVID-19 pandemic: A systematic review; https: // doi .org /10 .1016 /j.jcot .2020 . 06 .035

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