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.