Osteogenesis imperfecta (OI), commonly known as "brittle bone disease," is a genetic disorder characterized by bones that break easily, often with minimal or no apparent trauma. The condition results from defects in type I collagen, the primary protein building block of bone, leading to abnormal bone formation and reduced bone density. OI encompasses a spectrum of severity ranging from mild forms with few fractures to severe forms causing multiple fractures even before birth. While there is no cure for OI, modern orthopedic management has dramatically improved outcomes, allowing many children with OI to lead active, productive lives with proper treatment and support. Dr. Kumar provides comprehensive care for children with osteogenesis imperfecta, addressing both the frequent fractures and the progressive skeletal deformities that characterize this condition. The disorder is classified into several types (Type I through Type VIII), with Type I being mildest and Type II most severe (often lethal). Common features include multiple fractures throughout childhood, blue sclerae (blue-tinted whites of the eyes), hearing loss, dental abnormalities (dentinogenesis imperfecta), short stature, scoliosis and spinal deformities, and ligamentous laxity leading to joint hypermobility. Treatment requires a multidisciplinary approach combining orthopedic surgery, bisphosphonate medications, physical therapy, and supportive care. Surgical management for OI focuses on stabilizing fractures, correcting deformities, and preventing future fractures through intramedullary rodding procedures. Intramedullary rods are metal implants placed inside the long bones (femur, tibia, humerus) to provide internal support and prevent fractures and progressive bowing deformities. Dr. Kumar uses both telescoping rods (which elongate as the child grows) and fixed rods depending on the child's age and bone characteristics. The Fassier-Duval telescoping rod system is particularly valuable for younger children with growing bones. Rodding procedures are typically performed for recurrent fractures in the same bone, progressive angular deformities, or prophylactically in severely affected children to prevent fractures and improve mobility. Medical management with bisphosphonate medications (such as pamidronate or zoledronic acid given intravenously) has revolutionized OI care over the past two decades. These medications increase bone density, reduce fracture frequency, improve bone pain, and enhance mobility in most children with moderate to severe OI. Treatment typically begins in early childhood and continues through adolescence. Physical and occupational therapy are essential components of comprehensive care, focusing on safe strengthening exercises, mobility training with appropriate assistive devices, and activities of daily living adaptations. Aquatic therapy is particularly beneficial, allowing exercise in a low-impact environment. At Arthoscenter, Dr. Kumar collaborates with pediatricians, geneticists, endocrinologists, and rehabilitation specialists to provide holistic care for children with OI and their families. Our approach emphasizes fracture prevention through environmental modifications, safe handling techniques, and appropriate activity guidelines while promoting maximum independence and participation. Surgical outcomes have been excellent, with intramedullary rodding significantly reducing fracture frequency and improving ambulation in most children. Family education and psychological support are integral to our program, helping parents and children navigate the challenges of living with this lifelong condition while maintaining optimism about achievable functional goals.