Surgical stabilisation of the lower limb in osteogenesis imperfecta using the Sheffield telescopic intramedullary rod system

The Sheffield Expanding Intramedullary Rod System was developed after exper iencing problems with existing rod systems in the management of osteogenesi s imperfecta, Between 1986 and 1996 we treated 74 bones in the lower limb i n 28 children at a median follow-up of 5.25 years. We have reviewed 24 chil dren with a total of 60 rods. Before surgery, all children had had multiple fractures of the lower limb. At review eight patients had experienced no further fractures, but three ha d suffered five or more subsequently. Before initial stabilisation, 15 children had never walked, and only three (13%) used walking as their main means of mobility. After surgery, half of those who showed motor arrest were able to walk (p = 0.016). The number of patients able to walk, with or without aids, increased to 17 (p = 0.0001). We have experienced no evidence of epiphyseal damage after the procedure, a nd complication rates requiring rod exchange have been low (7%).