Related Experiment Video
Updated: Aug 14, 2026
An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice
Published on: November 13, 2016
Complications in the use of the Bailey-Dubow extensible nail
L E Zionts1, E Ebramzadeh, N S Stott
1Division of Pediatric Orthopaedics, Women's and Children's Hospital, Los Angeles, CA 90027, USA.
Insights
Extensible intramedullary nailing in children with osteogenesis imperfecta is linked to complications, particularly in those under 5 years old or with tibial implants. Avoiding technical errors can improve device longevity.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Biomaterials Engineering
Background:
- Osteogenesis imperfecta (OI) presents significant orthopedic challenges in children.
- Intramedullary nailing is a common surgical intervention for long bone fractures in OI.
- Extensible intramedullary nails offer adjustable length for growing bones.
Purpose of the Study:
- To identify risk factors associated with complications in pediatric patients undergoing extensible intramedullary nailing for osteogenesis imperfecta.
- To evaluate the incidence and nature of major and minor complications.
- To determine factors influencing the need for revision procedures.
Main Methods:
- Retrospective review of 40 extensible intramedullary nailing procedures in 15 children with osteogenesis imperfecta.
- Analysis of complication rates (major and minor) and associated factors.
- Survivorship analysis to assess the risk of revision surgery based on implantation site and technical errors.
Main Results:
- A total of 40 complications occurred (17 major, 23 minor).
- Major complications were more frequent in patients younger than 5 years at the time of nail insertion.
- Technical errors during insertion significantly increased the risk of revision procedures.
Conclusions:
- Extensible intramedullary nails appear most advantageous in the femur and for patients over 5 years old.
- Minimizing technical errors during insertion is crucial for enhancing the longevity of the implant.
- Further research may optimize the use of extensible nails in pediatric OI patients.
Abstract:
The results of 40 extensible intramedullary nailing procedures in 15 children who had osteogenesis imperfecta were reviewed to identify risk factors leading to complications of this method of treatment. There were 40 complications, 17 major and 23 minor. The 17 major complications led to 15 additional procedures, 10 of which were to remove or replace the implant. The prevalence of major complications was highest in patients who were younger than 5 years when the nail was inserted. Nails placed in the tibia tended to produce a higher incidence of major complications than did those placed in the femur, but this difference was not statistically significant. By survivorship analysis, patients had a greater risk of requiring a revision procedure when a technical error occurred at the time the nail was inserted. Patients who had nails placed in the femur tended to have a lower risk of needing revision surgery than did those who had nails placed in the tibia, but this difference was not statistically significant. The results suggested that the extensible nail is most advantageous in the femur and in patients older than 5 years. Avoiding technical errors when inserting the nail may improve the longevity of the device.
