Abstract

High complication rates and technical difficulties of intramedullary fixation in children with osteogenesis imperfecta has prompted the modification of existing rod systems. The Sheffield telescoping intramedullary road has T-piece which is permanently fixed and is expanded to reduce metaphyseal migration. This study analyses the outcome of this rod system over an 11 year period in two tertiary referral hospitals.

60 rods were inserted in the lower limbs of 19 children with osteogenesis imperfecta. All children had multiple fractures of the bones before rod insertion. 39 rods were inserted into femur, of which 3 were exchange and 4 revision procedures. 21 rods were inserted into tibia. Eight children had intramedullary rodding of both femur and tibia bilaterally. The outcome was measured in terms of incidence of refractures, mobility status, functional improvement and rod related complications.

Our series demonstrates that there is significant reduction in refractures and improvement in the functional status of children with osteogenesis imperfecta following intramedullary fixation. The frequent complication of T-piece separation and the need for re-operation has been overcome with Sheffield modification of rod design. But the incidence of the rod, particularly at the proximal end of femur remains high and further improvement in the design is desirable.

Footnotes

  • The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at Irish Orthopaedic Associaton, Secretariat, c/o Cappagh National Orthopaedic Hospital, Finglas, Dublin 11.