Osteolysis around the Fassier-Duval nail and spontaneous femur fracture in a young semi-professional swimmer with Osteogenesis Imperfecta type I: Case report and review of literature

A 12-year-old male patient with OI type I underwent percu-taneous osteotomies with the FD telescopic nail (diameter 5.6). The clinical and radiological follow-ups of the implant were satisfactory, with good bone callus formation and correct positioning of the nail. The patient was permitted to resume swimming from the 9 th post-operative month, though, unbeknownst to his caregivers, he began a semiprofessional freestyle swimming training load. As a result, the patient experienced acute thigh pain with immediate functional impotence 18 months after surgery. The X-rays showed an incomplete transverse fracture in the upper middle third of the femur. The patient was subsequently placed in a long leg cast, with no weight bearing for 3 weeks, and prescribed magnetotherapy until clinical and radiological healing was reached, 2 months later. We believe this case should give pause for thought as to which indications to give these patients with regard to sports activities, and the need to increase awareness in OI patients and their families. We also believe it is best to discourage, in these particular patients, any form of semi-professional competitive activity, including competitive swimming.