Operatively Treated Pelvic Ring Fractures in Adult Patient with Osteogenesis Imperfecta after Traumatic Injury: A Case Report.

Osteogenesis imperfecta (OI) is a rare heritable disorder of type I collagen that predisposes patients to recurrent fractures and skeletal deformities. Although fracture management in children with OI has been widely described, guidance for adult patients is comparatively limited. This is a report of the case of a 35-year-old man with OI who sustained right-sided sacroiliac diastasis and pubic rami fractures following a high-energy bicycle accident. The injury was treated with percutaneous screw fixation, achieving satisfactory reduction and stable fixation without perioperative complications. The patient advanced to full weight bearing at 12 weeks, and at 2-year follow-up demonstrated near-baseline function with Visual Analog Scale and Majeed Pelvic Scores that closely approximated those reported in non-OI populations. Radiographs showed no evidence of malunion or nonunion, though he continued to experience chronic low back pain. This case suggests that standard fixation strategies may be effective for selected adults with mild OI phenotypes, provided that preoperative planning accounts for the condition's distinctive biomechanical and hemostatic challenges.