title: Experience with Bailey-Dubow rodding in children with osteogenesis imperfecta.
abstract: OBJECTIVE
  The current report presents our experience with the use of Bailey-Dubow elongation rods in children with osteogenesis imperfecta.
  
  
  METHODS
  63 patients with osteogenesis imperfecta underwent a total of 186 primary intramedullary fixations with Bailey-Dubow rods during period 1984-1996. Most of them were inserted into the femur (54.3 %), followed by the tibia (38.2%) and the humerus (7.9%). Patients' age at operation ranged from 1-12 years and treatment-period varied from 1-10 years.
  
  
  RESULTS
  Insertion into the femur showed the lowest complication rate (21.0%). Patients either suffered from knee-joint migration of the distal nail (3.9%), proximal nail migration (7.9%), detached T-pieces from the sleeve (7.9%) or chronical nail infection (1.0%). Complication rate after tibia rodding was markedly higher (52.1%). Knee joint migration appeared in 8.5% and the distal piece of the rod migrated proximally in 38.0%, in 31.0% accompanied by recurrent antecurve deformity. Growth arrest and no elongation occurred in 5.6%. Results after humerus operation were by far least satisfying. None of the nails elongated adequately. 8 of the 14 Bailey-Dubow rods (57.1 %) required reoperation caused by migration and chronic nail infection, whereas reoperation rates amounted to 17.8% after femur and 29.6% after tibia insertion. However, just one refracture happened after adequate trauma (road accident), so that an extraordinary success of fracture prevention has to be scored.
  
  
  CONCLUSIONS
  We concluded that the use of Bailey-Dubow rods in early childhood can be recommended for the femur, whereas insertion into the tibia or humerus is associated with a considerable complication rate.
authors.affiliation: Orthopaedic Department, Krankenhaus der Augustinerinnen, Cologne, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Karbowski
authors.forename: M
authors.initials: M
authors.lastname: Schwitalle
authors.forename: R
authors.initials: R
authors.lastname: Brenner
authors.forename: H
authors.initials: H
authors.lastname: Lehmann
authors.forename: B
authors.initials: B
authors.lastname: Pontz
authors.forename: O
authors.initials: O
authors.lastname: Wörsdörfer
mesh_terms: D002648:Child; D002675:Child, Preschool; D004867:Equipment Design; D006801:Humans; D007223:Infant; D016268:Internal Fixators; D010013:Osteogenesis Imperfecta / Q000601:surgery*