Bent Telescopic Rods in Patients With Osteogenesis Imperfecta

Lee, R. Jay; Paloski, Michael; Sponseller, Paul D.; Leet, Arabella I.

doi:10.1097/bpo.0000000000000509

Cited by 22 publications

(20 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mean time to rod bending was 4.0 years (range 0.9-8.2 years). 17 We confirmed this mode of failure, as we found that 41% (n=7) of the 17 rods that failed to expand had bent. Transcortical migration due to proximal femur deformity, normally described in RRs with progressive deformity, occurred with one FD rod after initial central placement subsequent to proximal femur stress fracture.…”

Section: Discussionsupporting

confidence: 69%

See 1 more Smart Citation

Short-term comparison of the use of static and expandable intramedullary rods in the lower limbs of children with osteogenesis imperfecta

et al. 2021

View full text Add to dashboard Cite

BACKGROUND: Children with osteogenesis imperfecta suffer from frequent fractures and deformities due to skeletal fragility. Stabilisation of fractures, correction of deformity and intramedullary rodding result in decreased pain and improved function. Modern expandable intramedullary rods aim to provide lasting stability during growth, without an increase in complications. The aim of our study was to determine and compare the outcome of static Rush rods and expandable Fassier-Duval rods in terms of complications and reoperation rate. METHODS: We reviewed the records of a cohort of 17 children (seven female) with osteogenesis imperfecta (11 Sillence type III, six Sillence type IV) who were treated with intramedullary rods in the lower limb between 2011 and 2017. They had 64 rodding (38 femoral and 26 tibial) procedures (26 Rush rods and 38 Fassier-Duval rods). These were a primary procedure in 46, and a revision procedure after previous Rush rodding in 18 cases. RESULTS: The overall complication rate was 66% (n=42). There was a higher complication rate in the Rush rod group (81%, n=21) when compared to the Fassier-Duval group (55%, n=21)(p=0.035). The most frequent complication in the Rush rod group was distal deformity as the rod is outgrown (69%, n=18). The most frequent complication in the Fassier-Duval rod group was intramedullary migration due to a failure to expand (45%, n=17). Factors that were associated with increased risk of complications included younger age (p=0.031), type of rod (p=0.035), and deformity as an indication for surgery (77% complications, p=0.033). At a mean follow-up of 3.1 years, the reoperation rate in the Rush rod group was 58% (n=15). Comparatively, at a mean of 3.7 years follow-up, there were no reoperations in the Fassier-Duval group. CONCLUSIONS: Despite the numerous innovations, the surgical management of lower limb deformities and fractures in children with osteogenesis imperfecta remains challenging with a relatively high complication rate. The use of Fassier-Duval rods may result in a lower reoperation rate when compared to Rush rods, in the short term. Level of evidence: Level 4 Keywords: osteogenesis imperfecta, intramedullary rod, Rush rod, Fassier-Duval rod, fracture, deformity

show abstract

Section: Discussionsupporting

confidence: 69%

“…This confirms the findings of previous studies showing higher complication rates with the use of static rods. 2,9,[15][16][17] The main complication in the RR group was distal deformity, which occurred when the rod was outgrown (86% of complications in this group). This occurred despite bisphosphonate therapy.…”

Section: Discussionmentioning

confidence: 99%

Short-term comparison of the use of static and expandable intramedullary rods in the lower limbs of children with osteogenesis imperfecta

et al. 2021

View full text Add to dashboard Cite

show abstract

“…We attributed this difference to specific characteristics of other rods, which presented, in some cases, as robust fixation mechanisms on the distal portion, including intra-articular fixation of the knee; the same mechanism was not present for proximal fixation. 14 , 25 , 37 , 38 The TIR involves transchondral suturing for proximal fixation and a thread for distal fixation.…”

Section: Discussionmentioning

confidence: 99%

Effects of a telescopic intramedullary rod for treating patients with osteogenesis imperfecta of the femur

Rosemberg

Goiano

Akkari

et al. 2018

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

PurposeTo introduce a new model of telescopic intramedullary rod (TIR), evaluate its effects on treating patients presenting with moderate and severe osteogenesis imperfecta (OI) and to compare the findings with those of other telescopic rods.MethodsA total of 21 patients (nine girls and 12 boys; mean age at first operation, 6.6 years, 1.52 to 13.18) who underwent 52 femoral operations were monitored during a mean of 9.96 years (3.39 to 14.54). Patient characteristics, telescoping rod capability and its complications were examined.ResultsAccording to the Sillence classification, we investigated one patient with type I, nine with type III and 11 with type IV OI. Revision rates at up to five years (36%) were inferior to those found for the Fassier-Duval rod (46%). The main cause of revision was fracture (15 patients), followed by rod migration (nine), and infection (two). The rod exhibited higher telescopic capacity in boys than girls. Type III most commonly required an operation; the age group with the highest number of procedures was five to ten years. Male migration was the main cause of rod migration.ConclusionThe TIR has a satisfactory cost-benefit ratio with less complication rates and low production costs. The TIR is a feasible alternative to the commonly used Fassier-Duval rod.Level of EvidenceIV

show abstract

“…Common reasons for femoral FD nail revision included femoral fracture, bending of the rod, and proximal rod migration. [ 6 , 7 ]…”

Section: Discussionmentioning

confidence: 99%

Corrective osteotomy with retrograde Fassier-Duval nail in an osteogenesis imperfecta patient with bilateral genu valgum

Lin

Yang²,

Liu³

2017

Medicine

View full text Add to dashboard Cite

Rationale:The treatment of osteogenesis imperfecta (OI) requires a multidisciplinary approach to maximize function and reduce fracture incidence. The aim of this case report was to discuss an alternative surgical approach to stabilize a corrective osteotomy using the Fassier Duval (FD) system in an OI patient.Patient concerns:A 20-year-old OI woman presented with left thigh pain, gait disturbance, and bilateral genu valgus deformities.Diagnoses:Physical examination and standing radiographs revealed bilateral genu valgum with previous fixation implants in the femoral and the left tibia.Interventions:Staged surgery was performed. A previous Ender pin was removed from the left femur, and a FD nail was inserted in a retrograde fashion. An intercondylar fracture was encountered while inserting the female rod in the distal left femur. After removal of a previous Rush pin from the right femur, several complications were also encountered during FD nailing of the right femur. The tip threads of the FD male nail could not achieve adequate anchorage in the region of the greater trochanter. To prevent male nail dropping, a horizontal stop Kirschner pin was inserted close to the distal end of the female nail.Outcome:Despite perioperative problems such as rod dropping and occurrence of an intercondylar fracture of the left distal femur, bilateral retrograde nailing using the FD system was successful. An accurate entry portal is important when performing retrograde rodding. In addition, reaming the portal to a larger diameter in order to accommodate the large head of the female nail can prevent intraoperative intercondylar split, especially when combined with an osteotomy at the distal femur.Lessons:Selection of the proper surgical technique is dependent on both the surgeon's experience and the condition of the patient. Although not an optimal device, a FD nail can be used as an IM nail for corrective osteotomy at the distal femur in an adult OI patient with a small femoral IM canal.

show abstract

Bent Telescopic Rods in Patients With Osteogenesis Imperfecta

Abstract: Level III-retrospective review.

Cited by 22 publications

References 12 publications

Short-term comparison of the use of static and expandable intramedullary rods in the lower limbs of children with osteogenesis imperfecta

Short-term comparison of the use of static and expandable intramedullary rods in the lower limbs of children with osteogenesis imperfecta

Effects of a telescopic intramedullary rod for treating patients with osteogenesis imperfecta of the femur

Corrective osteotomy with retrograde Fassier-Duval nail in an osteogenesis imperfecta patient with bilateral genu valgum

Contact Info

Product

Resources

About