The choice of intramedullary devices for the femur and the tibia in osteogenesis imperfecta

Abstract

The results of intramedullary rodding of 50 femoral and 25 tibial segments were analyzed retrospectively. The techniques of femoral rodding included single Rush rodding, dual Rush rodding and Sheffield telescoping rodding. Single Rush rods or Sheffield rods were used in the tibia. The frequencies of fractures following rodding and implant-related complications and the interval between initial rodding and rod revision were analyzed. The longevity of the rods was evaluated by survival analysis. In the femur, dual Rush rods and Sheffield rods were equally effective and both were superior to a single Rush rod with reference to each of the outcome variables. The technique of dual Rush rodding was more demanding than telescoping rodding. In the tibia, a single Rush rod was as effective as a Sheffield telescoping rod. Based on our results, a single Rush rod would be the preferred implant in the tibia while in the femur, dual Rush rods or a Sheffield telescoping rod may be preferred.

Our Results of Modified Sofield Procedure in Lower Extremity Deformities with Osteogenesis Imperfecta

“…Nonunion is not rare in OI patients. The first and broadest study on nonunion was published by Gamble et al [29]. The authors observed 12 (19%) nonunion cases in 10 of 52 patients.…”

Fracture Healing under Intramedullary Insertion of Wires with Hydroxyapatite Coating

“…Основным недостатком интрамедуллярного остеосинтеза считается опасность повреждения сосудов и системы кровообращения ме-дуллярного канала, что ослабляет остеогенные и остео-индуктивные потенции плюрипотентных клеток стромы костного мозга [8]. Экспериментальные исследования показали, что введение в костномозговую полость даже тонкого имплантата вызывает значительные наруше-ния кровоснабжения медуллярного канала и внутренней части кортикального слоя [9].…”

Osteogenesis Imperfecta

“…The role of bisphosphonate treatment with non-union fractures is also unclear. Non-unions have been noted in 15% of children with osteogenesis imperfecta even prior to treatment with bisphosphonates (Agarwal and Joseph, 2005). There is one report of delay in healing following osteotomies but not fractures (Pizones et al, 2005).…”

“…This device also decreases the need for arthrotomies. However, other intramedullary devices continue to be used with good results (Boutaud and Laville, 2004;Cho et al, 2007;Cho et al, 2011;Joseph et al, 2005;Luhmann et al, 1998). Treatment of younger children and toddlers may require earlier revision because the length of the rods are short initially because of the size and length of the child's one.…”

“…This minimizes the injury to the soft tissue envelope and allows for some inherent rotational stability. The Fassier Duval technique also decreases the need for arthrotomies (Boutaud and Laville, 2004;Cho et al, 2007;Esposito, 2010;Fassier et al, 2006;Fassier and Glorieux, 2003;Joseph et al, 2005;Luhmann et al, 1998;Turman et al, 2006). Although most frequently utilized to correct femoral and tibial deformities, it is quite effective in the humerus (Figure 2A, B).…”