A Novel, Low-Cost Telescopic Nail Design for Prevention and Treatment of Osteogenesis Imperfecta Associated Long-Bone Pathological Fractures in Children.

Abstract

Telescopic nailing and intermittent doses of bisphosphonates are now considered the standard treatment for preventing long bone pathological fractures in osteogenesis imperfecta (OI) children. Even though the telescopic nail designs have evolved over time, we are yet to get an affordable, worldwide uniformly and easily available, surgeon-friendly telescopic nail with good rotational stability. We designed a telescopic nail with modifications in Küntscher nail (outer, hollow component) and square nail (inner, solid component). The distal end of the square nail has a slot to allow locking in the distal epiphysis using a threaded K wire. The interlocking geometry between the two nails allows reasonable rotational control while allowing only longitudinal movements. This novel, low-cost, rotationally stable telescopic nail design is a good alternative to existing telescopic nails in the market, especially for children from low and middle-income countries (LMIC) where affordability and uniform availability are a concern.