Abstract
We report the our experience of using the Sheffield intra-medullary telescoping nail system for managing recurrent fractures and deformity problems in the long bones of the lower limbs. 15 children with conditions like osteogenesis imperfecta, fibrous dysplasia and neurofibromatosis were operated from the years 1993 to 2001 and followed up for a mean period of five years nine months. The average age at the time of the initial nailing was six years. In all, 21 femurs and 10 tibiae were nailed.
A total of thirteen complications were noted in seven patients, including re-fractures with the nail-in-situ in seven bones, migration of the rods in four bones, fracture of the nail and one sub-clinical infection after femur nailing. Nine revision operations were necessary to address these problems including removal of the infected nail. All these revisions were successful. The estimated 5 year cumulative survival rate was 73% for femur and 75% for tibia. We have not experienced any evidence of epiphyseal damage after the procedure. All our patients can ambulate independently now.
Elongating intramedullary rods are ideal in children with any condition that can cause recurrent fractures or limb deformity as they improve walking capability and prevent further deformity.
The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.
