TELESCOPING INTRAMEDULLARY RODDING WITH BAILEY-DUBOW NAILS FOR RECURRENT PATHOLOGICAL FRACTURES IN CHILDREN WITHOUT OSTEOGENESIS IMPERFECTA

We reviewed four children with multiple, recurrent, pathologic fractur es caused by bone diseases, excluding osteogenesis imperfecta, and in whom multiple osteotomies with telescoping intramedullary stabilizatio n had been performed. The diagnoses were myelomeningocele in two child ren and Rett syndrome and fibrous dysplasia in one child each. Five lo ng bones were stabilized; four femora and one tibia. The average age a t surgery was 6 years 6 months; the average number of fractures that h ad occurred in the involved bone before surgery was 3.0 per bone. At a n average follow-up of 2 years 4 months, the average number of fractur es that had occurred after surgery in the stabilized bones was 0.2 per bone. There were no infections, nonunions, or rod complications. We b elieve that in the carefully selected patient, multiple osteotomies wi th intramedullary telescoping rod stabilization can be quite successfu l in solving the problem of recurrent fractures in children with disea ses other than osteogenesis imperfecta.