TREATMENT OF OSTEOGENESIS IMPERFECTA USING THE FASSIER-DUVAL TELESCOPIC ROD

This study aimed to assess the treatment of patients with Osteogenesis Imperfecta (OI) operated on with a telescopic Fassier-Duval (FD) rod in a querterenario hospital from 2010 to 2020.

Methods:

We analyzed indication for surgical treatment, causes of reoperation, complications and the effectiveness of telescoping rod.

Results:

The results were compared with the literature and with the same parameters from a previous study which a different telescopic rod developed by the same authors. This was a retrospective study based on the analysis of digital and radiographic clinical records. Fifteen patients with 21 FD rods were evaluated, most were used on the femur (18 rods or 85.7%), eight patients were female (53.3%), with a mean age of 10.47 (3.92 to 16.44) years, most of whom had type III Sillence (46.7%), with a mean follow-up of 5.22 (1.43 to 7.02) years. Seven rods (33.3%) had complications. The main indication was for fracture (57.1%). Regarding the ability to telescope, we observed that 15 rods (71.4%) followed the child's growth.

Conclusion:

We had good results using FD rods, similar to the data found in the literature and the data obtained with our rod. Level of Evidence III,Retrospective comparative study .

Keywords:
Osteogenesis imperfecta; Osteotomy; Joint Deformities; Acquired

FD rods		N = 21	Proportion (%)
Sex	Female	11	52.4%
Sex	Male	10	47.6%
Age at rodding procedure	< 14 years	16	76.2%
Age at rodding procedure	> 14 years	5	23.8%
Complications	Fracture	3	14.3%
	Loosening	3	14.3%
	Metallosis	1	4.8%
Laterality **	Right-side	10	47.6%
Laterality **	Left-side	11	52.4%
Bone	Femur	18	85.7%
Bone	Tibia	3	14.3%
Surgical indication	Deformity	4	19.0%
	Fracture	12	57.1%
	Migration	5	23.8%
Clinical Type	Type 1	4	19.0%
	Type 3	9	42.9%
	Type 4	8	38.1%

Sillence's Clinical Type	Patients (n = 15)	Patient proportion (%)	Rods (n = 21)	Rod proportion (%)
Type I	3	20.0%	4	19.0%
Type III	7	46.7%	9	42.9%
Type IV	5	33.3%	8	38.1%

Rods		N = 21	Proportion (%)	P-value
Telescoping	Yes	15	71.4%	<0.001
Telescoping	No	6	28.6%	<0.001

Telescoping (%)		Mean increase (%)	P-value
Sex	Female	12.2%	0.300
Sex	Male	7.3%	0.300
Laterality	Right-side	4.9%	0.037
Laterality	Left-side	14.4%	0.037
Bone	Femur	8.7%	0.220
Bone	Tibia	17.0%	0.220
Age range	< 14 years	12.4%	0.053
Age range	> 14 years	1.8 %	0.053
Follow-up time interval	0.5-3 years	1.3%	0.118
	3-5 years	13.4%
	5-10 years	12.0%
Surgical indication	Deformity	5.1%	0.640
	Fracture	11.1%
	Migration	10.8%
Clinical Type	Type I	7.0%	0.788
	Type III	11.6%
	Type IV	9.3%

Postoperative time interval	0.5-3 years	3-5 years	5-10 years	p-value
Telescoping mean (mm)	5.2	32.2	28.5	0.142
Telescoping mean %	1.3	13.4	12	0.118

Age at surgery (years)	Sex	Clinical Type	Bone	Surgical indication	Postoperative follow-up time (years)	Cause of the lack of telescoping
12.3	Female	III	Femur	Fracture	5.61	No bone growth
14.22	Female	IV	Femur	Migration	6.73	No bone growth
7.77	Female	IV	Femur	Deformity	0.88	Postoperative time
6.15	Male	IV	Femur	Deformity	1.65	No bone growth
18.31	Male	III	Femur	Migration	2.52	No bone growth
15.28	Male	III	Femur	Fracture	6.59	No bone growth

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[1] Correspondence: Ellen de Oliveira Goiano. Rua Dr. Cesário Motta Junior, 112, Vila Buarque, São Paulo, SP, Brasil. 01221-010 . ellengoiano@hotmail.com