Bone Abstracts

Goal: The use of intramedullary telescopic constructs for osteosynthesis in surgical correction of bone deformities in children with systemic skeletal disease can be complicated by delayed bony union, and the structural and functional pathology of bone in patients with these disorders do not always make it possible to avoid displacement of bone fragments and effectively correct the deformity.

Methods: Analysis of treatment of 11 patients of femoral and tibia deformity in patients with the skeletal system diseases (osteogenesis imperfecta – 2 patients with type I by Sillence; fibrous dysplasia - 3, vitamin D-resistant rickets - 4, vitamin D-dependent rickets - 1, Camurati-Engelmann syndrome - 1). Patients underwent corrective osteotomy of the femur and tibia with osteosynthesis using an advanced intramedullary locking rod with a T-shaped telescopic part. There were 19 surgical interventions: the hips - 7, tibia - 12.

Results: Average age was 9.8 years (range 8–11). The intramedullary construct consisted of a rod with proximal holes for locking screws, distal holes for locking screws in two planes, and a T-shaped telescopic part with holes of the same diameter and distance between them as in the rod. In the first stage, a corrective osteotomy was performed and stabilized by the intramedullary construct with distal locking of the rod and its T-shaped telescopic component. In the second stage, distal locking screws were removed after consolidation of the osteotomy, dynamizing the construct to growth mode. Correction of the deformity and bony union were achieved in all cases with no recurrence of the deformity or implant failure over five years follow-up.

Conclusion: The efficacy of the application of the improved intramedullary telescopic construct for the surgical correction of bone deformities in children with systemic skeletal disease wich is based on the principles of locking intramedullary osteosynthesis and telescoping intramedullary rod that grows.

Disclosure: The authors declared no competing interests.