In a 9-month-old with osteogenesis imperfecta type IV and a recent humeral fracture, what should be the initial priority in physical therapy?

• A. Weight bearing activities to decrease the rate of bone demineralization
• B. Parent and caregiver education on handling techniques for fracture management
• C. Initiating treatment with a light therapy psoriasis lamp
• D. Compensatory training secondary to the humeral fracture to avoid developmental delays

Answer: (B)

The main idea is that after a humeral fracture in an infant with osteogenesis imperfecta, the first goal of physical therapy is to protect the fracture and prevent new injuries through proper handling. This condition makes bones extremely fragile, so even small amounts of stress or improper lifting can cause additional fractures. Educating parents and caregivers on safe handling, proper support during lifting and dressing, appropriate positioning, and how to interact with the baby without stressing the injured arm establishes a safe daily routine and reduces pain and delay in healing. Only after caregivers are confident in safe handling would rehabilitation progress to gentle, non‑loading activities for the non-injured joints and development, rather than attempting weight bearing or advanced interventions. The other options don’t address fracture protection or caregiver safety at home, and some are not relevant to the infant’s immediate needs.