Report on new types of intramedullary rods and treatment effectiveness data for selection of intramedullary rodding in osteogenesis imperfecta.
Major advances in the surgical treatment of fractures of long bones in children with Osteogenesis Imperfecta (O.I.) have been made in the last several years. The current mainstay of treatment is bracing and active rehabilitation. When this fails surgery is indicated. The type of fixation device used is generally some type of stainless steel rod. The rod stabilizes the fracture as well as accepts the load across the fracture site thus enabling the fracture to heal. However, the current rods in use have complications. One such complication is cortical atrophy felt to be secondary to the removal of stress from the bone. This phenomena is called stress shielding. Stress shielding in the current rods prompted the study of two new types of rods which more closely approximate the modulus of elasticity of bone. The use of such rods should eliminate the problems of stress shielding. The following paper describes the effectiveness of the various intramedullary rods in the treatment of Osteogenesis Imperfecta fractures. It also reports on the initial results of two new types of intramedullary rods which more closely approximate the modulus of elasticity of bone and therefore may eliminate stress shielding. These rods may replace the stainless steel rods as the "gold standard" of therapy for surgical fixation of long bone fractures in children with Osteogenesis Imperfecta.
Reing
C M
CM
Fairfax Hospital Children's Hospital, Annandale, VA, USA.
D000818:Animals; D001284:Atrophy / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D004195:Disease Models, Animal; D004548:Elasticity; D005594:Fracture Fixation, Intramedullary / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D050723:Fractures, Bone / Q000473:pathology / Q000601:surgery*; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects / Q000592:standards* / Q000639:trends*; D010013:Osteogenesis Imperfecta / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D011817:Rabbits; D013314:Stress, Mechanical; D016896:Treatment Outcome