Intramedullary Elastic Transphyseal Tibial Osteosynthesis and Its Effect on Segmental Growth

Popkov, Dmitry; Кононович, Н. А.; Mingazov, E.R.; Shutov, R B; Barbier, Dominique

doi:10.15690/vramn.v70.i4.1410

Cited by 6 publications

(4 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Complications of with all types of rods are not rare. These include non-telescoping failures, joint intrusion, migration of parts of rod, fractures, delayed or non-union, bent nails and iatrogenic epiphysiodesis; overall a 35–40%-complication rate was reported [ 15 , 20 , 24 , 39 , 41 ]. Mechanical complications remain the main problem in all published series [ 15 , 20 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Use of flexible intramedullary nailing in combination with an external fixator for a postoperative defect and pseudarthrosis of femur in a girl with osteogenesis imperfecta type VIII: a case report

Popkov

2018

Strategies in Trauma and Limb Reconstruction

View full text Add to dashboard Cite

Telescopic rodding has been developed in order to obtain long-lasting osteosynthesis in the growing long bones of children with osteogenesis imperfecta (OI). The major and still unsolved drawback of any telescopic rod or nail design is a lack of rotational stability and, currently, no telescopic system allows immediate weight-bearing. When these problems are associated with insufficient longitudinal bone stability and diminished healing capacity, the result can be unfavourable causing secondary bone fragment displacement, delayed or non-union. This article presents a case report of operative treatment in a 9-year-old girl affected with OI type VIII complicated with postoperative defect and pseudarthrosis of the femur causing functional impairment with loss of walking ability. A combination of intramedullary flexible nailing and minimal external fixation was applied for treatment of femoral defect-pseudarthrosis in a girl of 9 years with OI type VIII. Intramedullary and extramedullary nails with wrapping of titanium nickel mesh subperiosteally provided osteosynthesis and deformity correction of the tibia of a small intramedullary canal diameter. Upright standing and walking with progressive weight-bearing was started 4 days after surgery. There were no septic or vascular complications nor complications related to Ilizarov fixator. Radiographs demonstrated bone union in the femur 46 days after surgery. At the follow-up visit 9 months after fixator removal, clinical alignment remained excellent without any relapse of deformity. Bone remodelling with restitution of medullary canal was noted on lower limb radiographs. The patient was able to stand and walk without pain with an aide or walker. At the follow-up visit 17 months after fixator removal, there was no decrease in achieved functional abilities and the treatment outcome remained satisfactory. Use of an external fixator with intramedullary nailing for treatment of postoperative pseudarthrosis in patient with severe OI (recessive form of OI, type VIII) provides longitudinal, rotational and angular stability. Furthermore, this approach ensured early functional activity and walking with full weight-bearing, both favourable conditions for bone tissue regeneration. The external fixator was applied for a short period and only for additional stability and not for progressive deformity correction or other manipulation. In addition, the combination of intramedullary and extramedullary nailing and subperiosteal titanium nickel mesh seems to be promising for osteosynthesis in the deformity correction of bones with small diameter in children with OI.

show abstract

Section: Discussionmentioning

confidence: 99%

Use of flexible intramedullary nailing in combination with an external fixator for a postoperative defect and pseudarthrosis of femur in a girl with osteogenesis imperfecta type VIII: a case report

Popkov

2018

Strategies in Trauma and Limb Reconstruction

View full text Add to dashboard Cite

show abstract

“…They did not lead to irreversible epiphysiodesis but caused a delay in bone growth with a loss of 15 to 18% of its length. We also found that the eccentric introduction of intramedullary nails through the medial malleolus resulted in ankle joint varus by the time of limb growth completion [ 10 ]. Radiographic study results correlated with histologically confirmed abnormalities of growth plates closure and a decreased rate of spongy bone formation in the distal tibial epiphysis on the side of the intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Earlier, we performed an X-ray diffraction study of the effect of the central retrograde and eccentric antegrade transphyseal placement of intramedullary elastic rods on the growth of the tibia without compromising its integrity. It was found that the segment lost the length and there was a change in the plane of distal articular surface inclination [ 10 ]. However, the morphology of the tibia in the conditions created by this previous study was not investigated.…”

Section: Introductionmentioning

confidence: 99%

Impact of Transphyseal Elastic Nailing On the Histostructure of the Tibia in Growing Animals (Non-Randomized Controlled Experimental Study)

Попков¹,

Силантьева²,

Горбач³

et al. 2018

Open Access Maced J Med Sci

View full text Add to dashboard Cite

BACKGROUND:The use of intramedullary elastic nailing is a method of choice for prevention of complications in children with osteogenesis imperfecta. However, the morphology of the growing long bones in the conditions created was not investigated.AIM:The purpose of our experiment was to study the impact of elastic intramedullary nailing on the histostructure of long bones in their physiological growth.METHODS:Six mongrel dogs underwent intramedullary elastic transphyseal nailing of the intact tibia with two titanium wires. Six months after nailing, a light-optical microscopic and histomorphometric study of the operated and contralateral tibiae was performed.RESULTS:It was found that asymmetric lesion of the distal physis induces a decrease in the height of the distal epimetaphysis. Adaptive changes in the hyaline cartilage of both articular ends were revealed corresponding to the initial stage of chondropathy. Intramedullary nailing promotes an increase in the thickness of the compact bone and the volume of the trabecular bone.CONCLUSIONS:Elastic transphyseal nailing of the intact tibia has a shaping effect which is expressed by an increase in the volume of spongy and compact bone, adaptive changes in the hyaline cartilage. Asymmetric damage to growth zones should be avoided to prevent deformities.

show abstract

“…The reoperation rate with tele scoping rods is close to 50% compared with 58-87% with regu lar rods, but this number includes repeated surgery due to fractures or bent nails 158 . In addition, telescoping rods pose the risks of not elongating or of impacting the growth plate 159 . The choice of 'open' osteotomy or percu taneous osteotomy using a minimally invasive approach depends on the severity of the deformity and on the shape of the bone.…”

Section: Rehabilitationmentioning

confidence: 99%

Osteogenesis Imperfecta

Marini¹,

Rajpar²

2013

Genetics of Bone Biology and Skeletal Disease

View full text Add to dashboard Cite

Intramedullary Elastic Transphyseal Tibial Osteosynthesis and Its Effect on Segmental Growth

Cited by 6 publications

References 17 publications

Use of flexible intramedullary nailing in combination with an external fixator for a postoperative defect and pseudarthrosis of femur in a girl with osteogenesis imperfecta type VIII: a case report

Use of flexible intramedullary nailing in combination with an external fixator for a postoperative defect and pseudarthrosis of femur in a girl with osteogenesis imperfecta type VIII: a case report

Impact of Transphyseal Elastic Nailing On the Histostructure of the Tibia in Growing Animals (Non-Randomized Controlled Experimental Study)

Osteogenesis Imperfecta

Contact Info

Product

Resources

About