Surgical Management of a Proximal Tibial Epiphyseal Fracture in a Pediatric Patient with Osteogenesis Imperfecta

Osteogenesis imperfecta (OI) is a heritable connective tissue disorder characterized by defective type I collagen synthesis, leading to reduced bone strength and increased susceptibility to fractures, often with minimal trauma. Fractures involving the tibial tuberosity are rare and typically occur in adolescents during periods of rapid growth, usually following high-demand activities. We report a case of a 14-year-old male with type I OI who sustained a displaced tibial tuberosity avulsion fracture with epiphyseal and intra-articular extension (Salter-Harris type III, Ogden type IIIA) following low-energy trauma. Surgical management was undertaken via open reduction and internal fixation using partially threaded lag screws through a medial parapatellar approach, with precautions tailored to the patient's underlying bone fragility. Postoperative recovery was favorable, and the patient remained under multidisciplinary follow-up. This case emphasizes the importance of individualized surgical planning and technique in patients with OI to ensure stable fixation and minimize complications associated with bone fragility.