title: Experience with the Fassier-Duval telescopic rod: first 24 consecutive cases with a minimum of 1-year follow-up.
abstract: BACKGROUND
  The new Fassier-Duval Telescopic IM System (FD-rod) has the advantage of a single entry point over the traditional telescopic rods such as the Bailey-Dubow or Sheffield rods. Although encouraging early results were presented by the originators of the technique at international meetings, there is no formal publication in the literature as yet.
  
  
  METHODS
  We performed a chart and x-ray review of the first 24 consecutive FD-rod insertions in 15 patients (age, 1.5 to 12.5 y) with a minimum of 1-year follow up (1 to 2.4 y) after implantation of femoral and/or tibial FD-rods. Diagnoses included with osteogenesis imperfecta (OI) (15 cases, 9 patients), and other conditions such as congenital tibial pseudarthrosis (CPT) in neurofibromatosis type 1 (NF1) (2 cases), and epidermal naevus syndrome (1 case). In patients with hypophosphataemic rickets (6 cases, 2 patients) the FD-rods were combined with an Ilizarov frame.
  
  
  RESULTS
  We found the OI patient group associated with a 13% reoperation rate (2 of 15 cases) for proximal rod migration and a 40% complication rate (6 of 15 cases): rod migration and limited telescoping (5) and intraoperative joint intrusion (1). There were no infections. All the NF1 CPT (2) and epidermal naevus syndrome (1) cases required several reoperations for nonunion, loss of fixation, shortening (negative telescoping), migration, and/or joint intrusion-mainly due to the severe underlying pathology with insufficient longitudinal or torsional stability and diminished healing capacity. In hypophosphataemic rickets (combined with Ilizarov frame fixation) we found a 50% complication rate (3 of 6 cases) and a 17% reoperation rate (1 of 6): 2 FD-rods did not telescope and 1 case of peroneal neuropraxia required neurolysis.
  
  
  CONCLUSIONS
  In our experience the technique of using FD rods is demanding and associated with some intraoperative and postoperative pitfalls. We are happy to continue its use in OI patients when there is longitudinal stability and sufficient bone healing. However, in circumstances of insufficient stability and bone healing potential, further stabilization that can be achieved with an Ilizarov frame may be beneficial.
authors.affiliation: Department of Orthopaedics, The Children's Hospital at Westmead, Sydney, Australia. oliverb1@chw.edu.au
authors.forename: Oliver
authors.initials: O
authors.lastname: Birke
authors.forename: Neville
authors.initials: N
authors.lastname: Davies
authors.forename: Mark
authors.initials: M
authors.lastname: Latimer
authors.forename: David Graham
authors.initials: DG
authors.lastname: Little
authors.forename: Michael
authors.initials: M
authors.lastname: Bellemore
mesh_terms: D001847:Bone Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004868:Equipment Failure; D053098:Familial Hypophosphatemic Rickets / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation / Q000379:methods; D006801:Humans; D018889:Ilizarov Technique; D007223:Infant; D008297:Male; D009984:Orthopedic Fixation Devices; D010013:Osteogenesis Imperfecta / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D016896:Treatment Outcome