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Published on: October 9, 2014
Rod diameter prediction in patients with osteogenesis imperfecta undergoing primary osteotomy
C Chotigavanichaya1, A Jadhav, R M Bernstein
1Shriners Hospital for Children, Los Angeles, California 90020-1199, U.S.A.
Journal of Pediatric Orthopedics
|July 4, 2001
Summary
Preoperative X-rays may inaccurately estimate the required intramedullary rod diameter in osteogenesis imperfecta patients. Most patients needed a smaller rod diameter than predicted by the narrowest inner bone diameter on X-rays.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Medical imaging
Background:
- Osteogenesis imperfecta (OI) often causes long bones to have an elliptical cross-section.
- Accurate intramedullary rod sizing is crucial for successful osteotomy and fixation in OI patients.
Purpose of the Study:
- To evaluate the accuracy of using preoperative radiographs to determine intramedullary rod diameter in children with osteogenesis imperfecta undergoing osteotomy.
Main Methods:
- The study correlated the narrowest inner bone diameter (NID) measured on preoperative radiographs with the actual rod diameter (RD) used on postoperative radiographs.
- Seventy-nine long bones from 27 pediatric patients with osteogenesis imperfecta were analyzed.
Main Results:
- Only 5% of bones had an NID equal to the RD.
- A significant majority (81%) of bones required an RD smaller than the NID.
- A positive correlation (0.76) existed between NID and RD, but NID was not a reliable predictor of RD.
Conclusions:
- Preoperative radiographic measurement of the narrowest inner bone diameter is an unreliable method for predicting the appropriate intramedullary rod diameter in pediatric osteogenesis imperfecta patients.
- Elliptical bone morphology in OI complicates accurate rod sizing based solely on standard radiographic measurements.
