- 期刊
- OpenAccess
Fassier-Duval telescoping rod in management of osteogenesis imperfecta deformity: A preliminary report
摘要
Osteogenesis imperfecta (OI) is the most common inherited disease that causes bone fragility. The use of Fassier-Duval telescoping rod (FD rod) has become well established in developed countries with reported lower complication and reoperation rates. The FD rod was introduced to Taiwan in January 2015. This is a preliminary report in reviewing our results of surgical procedures, complications, and functional performance. We retrospectively reviewed 5 OI children (2 boys and 3 girls) who had FD rod procedures in 19 limbs at our institution from April 2015 to April 2016. The average age at surgery was 5 years old (range, 3-12 years old), with a minimum of 16 months follow up (16-28 months). Medical records, preoperative, and postoperative follow-up radiographs were reviewed to evaluate the time of union, complications of each limb. For functional performance, we collected range of motion of the associated joints and the Gillette Functional Assessment Questionnaire (FAQ) obtained for evaluation. The mean surgical time and average blood loss for the first 7 segments were 93.9 minutes and 92.9 mL respectively, and improved to 75.8 minutes and 37.5 mL for the next 12 segments. The average union time was 5.2 months (range, 3-11 months). Among 19 segments, 6 segments (31.6%) had limitation of ROM at 3 months follow up, while only 3 segments (15.8%) remained limited ROM at 12 months follow up. After surgery, all 5 patients were able to stand and 3 patients able to walk at 1 year follow up. An average of 1.8-point FAQ improvement was observed at 1 year postoperatively. Complications included 3 rod threads cross physis, 2 rod migrations, and 2 refractures which reached union with a short period of splinting. No re-operations were required up to our last follow-up. This is the first study in Taiwan regarding the use of FD IM rods in OI patients. The results are encouraging with a low complication rate, fewer reoperations, great improvement in functional performance, and patient satisfaction.