Surgical stabilisation of the lower limb in osteogenesis imperfecta using the Sheffield telescopic intramedullary rod system

Abstract

The Sheffield Expanding Intramedullary Rod System was developed after experiencing problems with existing rod systems in the management of osteogenesis imperfecta. Between 1986 and 1996 we treated 74 bones in the lower limb in 28 children at a median follow-up of 5.25 years. We have reviewed 24 children with a total of 60 rods. Before surgery, all children had had multiple fractures of the lower limb. At review eight patients had experienced no further fractures, but three had suffered five or more subsequently. Before initial stabilisation, 15 children had never walked, and only three (13%) used walking as their main means of mobility. After surgery, half of those who showed motor arrest were able to walk (p = 0.016). The number of patients able to walk, with or without aids, increased to 17 (p = 0.0001). We have experienced no evidence of epiphyseal damage after the procedure, and complication rates requiring rod exchange have been low (7%).

Fassier–Duval femoral rodding in children with osteogenesis imperfecta receiving bisphosphonates: Functional outcomes at one year

“…The non-elongating rods had a 3.5 times greater rate of re-operation than the elongatingtype rods, and the time period during which the non-elongating rods remained in place was statistically significantly shorter than the elongating-type rods. Modifications to the original technique were made to decrease the risk for complications [14][15][16][17]. Despite being the standard for several decades, a high incidence of mechanical complications (migration, disconnection of T-parts) remain with the Bailey-Dubow telescopic rod [18].…”

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

“…Since the flat nails used in a classical Sofield technique falls short over time due to the increased bone length, new implant designs have been investigated. Bailey and Dubow [19] designed a new telescopic nail that can be fixed to the bone with T-shaped ends and get longer as the bone becomes longer. The incidence of re-operation reduced, since the bone was not without fixation due to the nail getting longer with increased bone length.…”

Interlocking Telescopic Rod for Patients with Osteogenesis Imperfecta

“…However, the Bailey-Dubow elongating nail has been associated with a high complication rate, particularly related to the T-piece 6,9-15 . The Sheffield telescopic rod system, a modification of the Bailey-Dubow nail, eliminated T-piece-related complications by permanently fixing the Tpiece to the sleeve 10,17 , but it shares the problems of traumatic insertion and rod migration with its predecessor 19,20 . Placement of an obturator with a T-piece at the distal fragment is an invasive procedure, especially in the tibia.…”

“…The sleeves are of the same shape and dimension as those used in the telescopic intramedullary rod system (Sheffield Rod; Downs Surgical, Sheffield, England) 10,17 . The obturators (Dyna-Locking Telescopic Rod; U&I, Gyeonggi, Korea) have the same diameters as those of the Sheffield rod system.…”