[Experiences with different telescope nails in treatment of pediatric osteogenesis imperfecta].
OBJECTIVE
The present study aims to examine and compare results after intramedullary rodding of long bones with the original Bailey/Dubow-nail and two modifications.


METHODS
During the period 1985 to 1995 21 patients with an average age of 6.3 years (2-11 yrs) underwent intramedullary rodding of 83 long bones. Therefore 38 original Bailey/Dubow-nails, 36 nails with distal screws and 9 nails with distal K-wires were used. The mean observation period amounted to 5.7 years after insertion. Operation success was judged by bone growth, rod elongation, complications, implantation period, revision- and refracture rate.


RESULTS
Bone growth was about 90.6% of the normal value accompanied by an elongation of 71.4%. Best results could be achieved by the use of conventional nails, whereas nails with distal screw or K-wires showed most disturbance. Complications had to be scored in 33.7% and mainly consisted of rod migration with cortical perforation (15.7%), metaphyseal position of the distal screw (9.6%) or no elongation (6.0%). Average implantation period was 4.6 years with a 66.3% revision rate. Refractures after inadequate trauma happened in 3 cases (3.6%) after insertion of the screw-type nail.


CONCLUSIONS
The use of elongation rods in children with osteogenesis imperfecta promises successful fracture prevention and a comparably long implantation period. However, the original Bailey/Dubow-nail showed best results although the modified nails had been expected to be superior.
Karbowski
A
A
Orthopädische Abteilung, Krankenhaus der Augustinerinnen, Köln.
Schwitalle
M
M
Eckardt
A
A
D001858:Bone Nails; D001863:Bone Screws; D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation*; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D010013:Osteogenesis Imperfecta / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D011859:Radiography; D012086:Reoperation