Modified Sofield-Millar operation: less invasive surgery of lower limbs in osteogenesis imperfecta

Abulsaad, Mazen; Abdelrahman, Ashraf

doi:10.1007/s00264-008-0515-1

Cited by 28 publications

(16 citation statements)

References 24 publications

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“…Femoral angulation upon the K-wire migration from the cortex was also common among our patients; however, revision was not performed on all cases. In the literature, several articles on surgeries with non-extending nails report that the mean duration of revision was 2 to 2.5 years [11], and the mean time was 28 months for total revision surgeries in our series.…”

Section: Discussionmentioning

confidence: 99%

“…Most of the OI forms are associated with mutations in the type I collagen genes [1,[7][8][9]. Although several surgical techniques have been identified to treat deformities due to OI, the basic surgical principle is multiple osteotomies, fixation, and intramedullary nailing [10][11][12]. In the present study, we aimed to present our results of the modified Sofield procedure for OI-related lower extremity deformities.…”

Section: Introductionmentioning

confidence: 99%

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

Batur¹,

Demir²

2017

J Bone Res

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Introduction: Osteogenesis Imperfecta (OI) is a connective tissue disorder, which is the most common cause of genetic osteoporosis characterized by long bone deformities and fractures. The key defect is the qualitative and quantitative lack of type I collagen. The primary target in these patients is to fix deformities and to prevent fractures. The surgical application is often a basic surgical technique known as "Shish Kebab" osteotomy and mainly based on the principle of multiple osteotomies, fixation, and intramedullary nailing. In the present study, we present our results of the modified Sofield procedure for osteogenesis imperfecta-related lower extremity deformities.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Batur¹,

Demir²

2017

J Bone Res

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“…In children with severe forms of OI, the long bones are narrow and often not suitable for telescoping rods [ 13 , 35 ]. In such a situation, regular or elastic nailing achieves the required outcomes [ 16 , 21 , 24 , 36 ].…”

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

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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.

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“…Li et al [3] and Abulsaad [19] performed a modified Sofield-Millar operation to address this problem. This will devascularize the intercalary bone fragment.…”

Section: Discussionmentioning

confidence: 99%

Surgical management of long bone pseudarthrosis with severe limb length discrepancy in osteogenesis imperfecta

Gupta

Chow

2013

Journal of Pediatric Orthopaedics B

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We report a three-stage approach in managing an 18-year-old boy with osteogenesis imperfecta who had pseudarthrosis of the left femur with 150° anterior angulation and 9.5 cm shortening. Severe long bone deformity and pseudarthrosis in osteogenesis imperfecta are difficult to manage because of the relative shortening of the surrounding soft tissue and bone fragility. Our staged approach included excision of the pseudarthrosis, gradual soft tissue lengthening by external fixator, and a modified Sofield-Millar operation, to achieve union, deformity, and limb length correction without compromising much of the bone length. The patient was able to walk with support within 3 months and independently at 1 year. In this report, the management of the nonunion in osteogenesis imperfecta is discussed, with a focus on its difficulties and the management principles.

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Modified Sofield-Millar operation: less invasive surgery of lower limbs in osteogenesis imperfecta

Cited by 28 publications

References 24 publications

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

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

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

Surgical management of long bone pseudarthrosis with severe limb length discrepancy in osteogenesis imperfecta

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