Abstract
High complication rates and technical difficulties of intra-medullary fixation in children with osteogenesis imperfecta has prompted the modification of existing rod systems. The Sheffield telescoping intramedullary rod 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.
32 rods were inserted in the lower limbs of 11 children with osteogenesis imperfecta. All children had multiple fractures of the bones before rod insertion.24 rods were inserted into femur, of which 3 were exchange procedures for complications. 8 rods were inserted into tibia. 4 children had intramedullary rodding of all the 4 lower limb bones. The outcome was measured in terms of mobility status, incidence of refractures and rod related complications. Complications encountered include 2-rod migrations, one instance each of broken rod, bent rod and valgus drift in the tibia.There was no instance of epiphyseal damage or growth arrest.
Our series demonstrates that there is significant reduction in refractures and improvement in the mobility status in children with osteogenesis imperfecta following intramedullary fixation. The frequent complication of T-piece separation and the need for reoperation has been overcome with Sheffield modification of rod design. Though the incidence of rod related complications remain high, our study concludes that Sheffield rod system compares favourably with the existing intramedullary devices for osteogenesis imperfecta in the literature.
The abstracts were prepared by Mr Ray Moran. Correspondence should be addressed to him at the Irish Orthopaedic Association, Secretariat, c/o Cappagh Orthopaedic Hospital, Finglas, Dublin
