The results of Bogdanov and Bitchuk rods application for deformity correction of the low extremities in patients with osteogenesis imperfect
Treatment of low extremities deformities in children with osteogenesis imperfect is still actually under 40 years. There are a lot of surgical methods, but number of complications is still high (from 30 to 50–60 %).
Purpose: to make retrospective study of surgical results after deformities correction in children with osteogenesis imperfect with Bogdanov and Bitchuk rods.
Methods: we studied data of 4 children (age 7–16 years old) with osteogenesis imperfect after 10 corrective surgeries with intramedullary fixators. Bitchuk rods were used in 2 femur segments and 2 tibia segments, Bogdanov rods-in 3 femur and 3 tibia segments. Low extremities deformities were 25°–122°, that limited loading and kinematic patient’s activity. Varus deformity was observed in 5 segments, valgus — 5, antecurvation — 10 segments.
Results: the primary correction of deformity was achieved in all cases. In postoperative period fractures of the 4 rods were found (3 Bogdanov and 1 Bitchuk). Among them in 3 patients fracture fragments were consolidated with previous deformity, in 1 patient — femur fixator was changed. In 4 tibia segments fractures were consolidated with correction but with the fracture of blocked screws. Reoperation was needed in 1 case after usage of Bitchuk rod.
Conclusions: Bitchuk intramedullary rods are better compare with Bogdanov rods for surgical correction of deformities in children with osteogenesis imperfect due to device design and the presence of blocked screws. It helps to achieve proper stability and to avoid deformity appearance. But the number of complications is high after the application of the both rods. There is need to perform further design of devices.
Full Text:PDF (Русский)
Gamble, J. G., Strudwick, W. J., Rinsky, L. A., & Bleck, E. E. (1988). Complications of intramedullary rods in osteogenesis imperfecta. Journal of Pediatric Orthopaedics, 8(6), 645-649. doi:10.1097/01241398-198811000-00003
Kocher, M. S., & Shapiro, F. (1998). Osteogenesis imperfecta. Journal of the American Academy of Orthopaedic Surgeons, 6(4), 225–233.
Rosemberg, D. L., Goiano, E. O., Akkari, M., & Santili, C. (2018). Effects of a telescopic intramedullary rod for treating patients with osteogenesis imperfecta of the femur. Journal of Children's Orthopaedics, 12(1), 97-103. doi:10.1302/1863-2548.12.170009
Lammens, J., Mukherjee, A., Van Eygen, P., & Fabry, G. (1991). Forearm realignment with elbow reconstruction using the Ilizarov fixator. A case report. The Journal of Bone and Joint Surgery. British volume, 73-B(3), 412-414. doi:10.1302/0301-620x.73b3.1670440
McHale, K. A., Tenuta, J. J., Tosi, L. L., & McKay, D. W. (1994). Percutaneous intramedullary fixation of long bone deformity in severe osteogenesis imperfecta. Clinical Orthopaedics and Related Research, 305(1), 242-248. doi:10.1097/00003086-199408000-00030
Middleton, R., & Frost, R. (1987). Percutaneous intramedullary rod interchange in osteogenesis imperfecta. The Journal of Bone and Joint Surgery. British volume, 69-B(3), 429-432. doi:10.1302/0301-620x.69b3.3294840
Middleton, R. (1984). Closed intramedullary rodding for osteogenesis imperfecta. The Journal of Bone and Joint Surgery. British volume, 66-B(5), 652-655. doi:10.1302/0301-620x.66b5.6501356
Joseph, B., Rebello, G., & Chandra Kant, B. (2005). The choice of intramedullary devices for the femur and the tibia in osteogenesis imperfecta. Journal of Pediatric Orthopaedics B, 14(5), 311-319. doi:10.1097/01202412-200509000-00001
Nicolaou, N., Bowe, J. D., Wilkinson, J. M., Fernandes, J. A., & Bell, M. J. (2011). Use of the sheffield telescopic intramedullary rod system for the management of osteogenesis imperfecta. The Journal of Bone and Joint Surgery-American Volume, 93(21), 1994-2000. doi:10.2106/jbjs.j.01893
Ryöppy, S., Alberty, A., & Kaitila, I. (1987). Early semiclosed intramedullary stabilization in osteogenesis imperfecta. Journal of Pediatric Orthopaedics, 7(2), 139-144. doi:10.1097/01241398-198703000-00004
Stockley, I., Bell, M., & Sharrard, W. (1989). The role of expanding intramedullary rods in osteogenesis imperfecta. The Journal of Bone and Joint Surgery. British volume, 71-B(3), 422-427. doi:10.1302/0301-620x.71b3.2656718
Zionts, L. E., Ebramzadeh, E., & Stott, N. S. (1998). Complications in the use of the bailey-dubow extensible nail. Clinical Orthopaedics and Related Research, 348, 186-195. doi:10.1097/00003086-199803000-00029
Monti, E., Mottes, M., Fraschini, P., Brunelli, P., Forlino, A., Venturi, G., Doro, F., Perlini, S., Cavarzere, P., & Antoniazzi, F. (2010). Current and emerging treatments for the management of osteogenesis imperfecta. Therapeutics and Clinical Risk Management, 6, 367–381.
Palatnik, Y., & Rozbruch, S. R. (2011). Femoral reconstruction using external fixation. Advances in Orthopedics, 2011, 1-10. doi:10.4061/2011/967186
Porat, S., Heller, E., Seidman, D. S., & Meyer, S. (1991). Functional results of operation in osteogenesis imperfecta. Journal of Pediatric orthopaedics, 11(2), 200-203. doi:10.1097/01241398-199103000-00012
Bitchuk, D. D. (1987). Device for fick-fixing fragments of bones. USSR. Patent 1351594 SU. (in Russian)
Bitchuk, D. D. (1988). Surgical treatment of multi-lobed breaks of long bones and their defects: of abstract doctor of medical sciences. Kuibyshev. (in Russian)
Sillence, D. O., Senn, A., & Danks, D. M. (1979). Genetic heterogeneity in osteogenesis imperfecta. Journal of Medical Genetics, 16, 101–116.
Copyright (c) 2018 Sergey Khmyzov, Andrey Pashenko
This work is licensed under a Creative Commons Attribution 4.0 International License.