Initial Experience With Percutaneous IM Rodding of the Humeri in Children With Osteogenesis Imperfecta

Area of Science:

• Pediatric Orthopedics
• Skeletal Dysplasias
• Biomedical Engineering

Background:

• Osteogenesis imperfecta (OI) frequently causes humeral deformities and fractures in children.
• Intramedullary elongating rods are utilized to address these complex orthopedic challenges.

Purpose of the Study:

• To evaluate the surgical outcomes of using the Fassier-Duval (FD) intramedullary elongating rods in pediatric patients with osteogenesis imperfecta.
• To assess the efficacy and complication rates associated with FD rodding for humeral deformities and fractures.

Main Methods:

• Retrospective review of 18 pediatric OI patients (35 humeri) treated with FD rodding between 2005 and 2013.
• Concurrent bisphosphonate treatment was administered to all patients.
• Surgical techniques included closed, percutaneous, or open osteotomies.

Main Results:

• 65.7% of humeri (23/35) showed acceptable results with a mean follow-up of 43 months.
• Revision surgery was required in 34.3% of cases (12/35) for reasons including migration, hardware failure, nonunion, and malunion.
• Mean follow-up for revised cases was 35 months.

Conclusions:

• The Fassier-Duval system is a reasonable option for improving comfort and function in children with OI-related humeral deformities and fractures.
• FD system use may lead to decreased revision rates and less morbid instrumentation compared to other methods.