Experience with Bailey-Dubow rodding in children with osteogenesis imperfecta

Aim: The current report presents our experience with the use of Bailey-Dubo w elongation rods in children with osteogenesis imperfecta. Material and methods: 63 patients with osteogenesis imperfecta underwent a total of 186 primary intramedullary fixations with Bailey-Dubow rods during period 1984-1996. Most of them were inserted into the femur (54.3%), follo wed by the tibia (38.2%) and the humerus (7.9%). Patients' age at operation ranged from 1-12 years and treatment-period varied from 1-10 yea rs. Results: Insertion into the femur showed the lowest complication rate (21.0 %). Patients either suffered from knee-joint migration of the distal nail ( 3.9%), proximal nail migration (7.9%), detached T-pieces from the sleeve (7 .9%) or chronical nail infection (1.0%). Complication rate after tibia redding was markedly higher (52.1%). Knee joi nt migration appeared in 8.5% and the distal piece of the rod migrated prox imally in 38.0%, in 31.0% accompanied by recurrent antecurve deformity. Gro wth arrest and no elongation occurred in 5.6%. Results after humerus operat ion were by far least satisfying. None of the nails elongated adequately. 8 of the 14 Bailey-Dubow rods (57.1%) required reoperation caused by migrati on and chronic nail infection, whereas reoperation Fates amounted to 17.8% after femur and 29.6% after tibia insertion. However, just one refracture h appened after adequate trauma (road accident), so that an extraordinary suc cess of fracture prevention has to be scored. Conclusions: We concluded that the use of Bailey-Dubow rods in early childh ood can be recommended for the femur, whereas insertion into the tibia or h umerus is associated with a considerable complication rate.