Monish has had 10 fractures since he was born, and he’s just 18 months old. The toddler’s fragile condition is due to a rare bone disease called osteogenesis imperfecta, or glass bone disease. The caretakers at Shishu Mandir, a home for children where Monish was brought in when he was just a few days old, say they did not realise something was wrong until they took him to be vaccinated recently. Monish’s doctor, Dr Chidananda P [...]

What is temporary brittle bone disease? A special type of OI has become recognised in the last 25 years. In this, fractures occur in the first year of life and largely in the first six months. The identification of this disorder is still controversial, in part because the cause is not yet known. The disorder is more common in infants born before term and in twins. In some cases there are minor features of collagen [...]

How common is hearing loss in OI? About 50 per cent of people with OI find that they have impaired hearing with an onset mainly in the teenage years or early adult life. Not everyone is affected and, of those who have no hearing loss at the age of 50, relatively few become deaf thereafter. Hearing loss in OI is most commonly due to problems in the small bones in the middle ear, which may [...]

What about older women with OI? We know that after the menopause, women with OI lose bone like anybody else. This bone loss can be prevented with hormone replacement therapy (HRT). Because people with OI already have bones that are prone to fractures, women with OI should consider taking HRT from approximately the time of the menopause. Like any drug treatment, HRT has advantages and disadvantages. On the positive side, HRT preserves the bones and relieves menopausal [...]

What treatment can be given? The mainstay of treatment is competent orthopaedic care at the time of fractures, to ensure that each fracture heals in a good position. Patients should be mobilised as early as possible to minimise the loss of bone due to immobilisation. In some circumstances ‘rodding’ operations, in which fixed or telescopic metal rods are inserted into the shafts of bones, are very helpful – particularly in children with frequent fractures or [...]