Experience with different elongation rods in the treatment of osteogenesisimperfecta during childhood

Objective: The present study aims to examine and compare results after intr amedullary redding of long bones with the original Bailey/Dubow-nail and tw o modifications. Patients and methods: During the period 1985 to 1995 21 pa tients with an average age of 6.3 years (2-11 yrs) underwent intramedullary redding of 83 long bones. Therefore 38 original Bailey/Dubow-nails, 36 nai ls with distal screws and 9 nails with distal K-wires were used. The mean o bservation period amounted to 5.7 years after insertion. Operation success was judged by bone growth, rod elongation, complications, implantation peri od, revision- and refracture rate. Results: Bone growth was about 90.6 % of the normal value accompanied by an elongation of 71.4 %. Best results coul d be achieved by the use of conventional nails, whereas nails with distal s crew or K-wires showed most disturbance. Complications had to be scored in 33.7 % and mainly consisted of rod migration with cortical perforation (15. 7 %), metaphyseal position of the distal screw (9.6 %) or no elongation (6. 0 %). Average implantation period was 4.6 years with a 66.3 % revision rate . Refractures after inadequate trauma happened in 3 cases (3.6 %) after ins ertion of the screw-type nail. Conclusions: The use of elongation rods in c hildren with osteogenesis imperfects promises successful fracture preventio n and a comparably long implantation period. However, the original Bailey/D ubow-nail showed best results although the modified nails had been expected to be superior.