Сomplications in using different types of intramedullar telescopic fixators in children with osteogenesis imperfecta

Abstract

Treatment of patients with osteogenesis imperfecta (OI) is a com­plex problem in orthopedics. The most effective method of surgi­cal correction of long bone deformities in OI is the use of Fassi­er-Duval rod. However, a significant number (35 %) of its as­sociated complications (instability, migration and lock eruption, no extension during bone growth, bone deformity and fractures in terms of loading, bone fractures) leads to development of the new approaches. In Sytenko Institute of Spine and Joint Pathol­ogy designed intramedullary telescopic fiction device (ITF), which combines the principles of rotational and axial stability. Objective:to analyze the complications of treatment in OI chil­dren after fixation of long bones by means of rotary ITF stability and without it. Methods: we performed 28 surgeries in 9 patients with combined deformations of the bones of the lower limbs, us­ing ITF (5 rotary unstable, made of stainless steel and 23 rotary-stable — rods in 2 cases made of stainless steel, 21 — with tita­nium alloy). Results: after the use of rotary unstable ITF, eternal immobilization was longer for 10– 14 days, and recovery time range of motion in adjacent joints were longer by 7 days on av­erage compared with the group of patients who used stable rota­ry ITF. There was the following symptoms: violation of blocking wires, deformation and limb segment with ITF migration, ab­sence of ITF lengthening, limb fracture with ITF. Complications from the use of rotary unstable ITF was 60 %, and after rotary-stable — 17.4 %. Conclusions:the use of rotary stable ITF cor­recting deformities of long bones of the extremities in patients with OI is more efficient and leads to less (17.4 %) complica­tions.