Complications After Intramedullary Fixation Treatment of Patients With Osteogenesis Imperfecta: Telescopic Versus Non-Telescopic Implants.

Abstract

Introduction The treatment of musculoskeletal pathologies in osteogenesis imperfecta aims to provide the maximum possible function by preventing bone fractures and progressive deformities. Despite the development of implants used in the surgical treatment of osteogenesis imperfecta, there is no consensus on the most appropriate method for the correction of skeletal deformities. The aim of this study was to compare telescopic and non-telescopic implants in terms of postoperative complications. Methods Twenty-three patients who were operated on for the diagnosis of osteogenesis imperfecta between 2005 and 2018 were retrospectively analyzed. Demographic data, follow-up times, and the total number of surgeries and complications were recorded. The operated bones were divided into two groups according to whether the intramedullary fixation material used was telescopic or not. Results Twenty-one of 23 patients were included in the study due to the use of intramedullary fixation material in the operation. The mean age was 10.1 ± 2.9 years, and the mean follow-up period was 8.9 ± 3.5 years. Intramedullary fixation was applied to 43 long bones in 21 patients due to fracture or deformity. At least one complication was encountered in nine of 14 bones with telescopic implants and in 27 of 29 bones with non-telescopic implants. Major complications requiring surgical treatment were seen in seven bones of the telescopic implant group and 27 bones of the non-telescopic implant group. Conclusion The use of telescopic implants relatively reduces the complication rate and the need for repetitive surgery in patients with a diagnosis of osteogenesis imperfecta. However, the number of complications is still as high as with non-telescopic implants.