IJOCP | March 2015| Volume 2| Issue 1 | Page
Conference: Bangalore Orthopaedic Society Annual Conference BOSCON-2015,India [Click for Full details]  

Authors: Dr. Sandesh

Authors Affiliations: St.John’s Medical College

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Abstract                                                                                                                 

Introduction:

Children with Osteogenesis imperfecta and Congenital Pseudoarthrosis tibia are commonly treated with non telescopic nail systems which fail to keep up with the growing bone resulting in multiple surgeries. The use of telescopic nails which provide stable fixation as an intramedullary device, prevents development of deformity, accommodates the growing bone, reduce number of surgeries in these children, is gaining momentum.

We present our experience in treating these patients using telescopic nailing system in children.

Methods:

There were a total of 21 limbs, in 12 patients 9 male and 3 female.

A: Osteogenesisimperfect group (OI):

There were8 patients, 6 males, 2 females, all these patients underwent antegrade / retrograde percutaneous telescopic nailing with percutaneous osteotomy. 17 percutaneous nailing was carried out amongst which 10 was for femur, 7 for tibia. Post operatively hip spica was applied for children with involvement of femur and above knee cast for those with only involvement ofTibia.  All patients were followed up once a month for first 6 months and once in 3 months thereafter, regular radiographs were taken and weight bearing was allowed once clinico-radiological union was confirmed.All patients received oral calcium, bisphosphonate and vitamin D.

B: Congenital Pseudoarthrosis tibia group (CPT):

There were 4 patients with CPT treated with telescopic nail, 3 patients were male and 1 patient was female.All patients underwent excision of the pseudoarthrotic segment, contralateral/ipsilateral fibular strut graft, and cancellousbone grafting. Periosteal sleeve wrapping done in 2 patients, post operatively patients were put on above knee cast. Patients were regularly followed once a month for the first 6 months and once in 3 months thereafter,regular radiographs were taken and weight bearing was allowed once clinico-radiological union was confirmed.

Results:

Of the 21 limbs, all achieved union except 2 patient with CPT. In one patient only male part of the telescopic nail was used due to narrow marrow cavity, which got bent (revision nailing done), 3 limbs there was back out of the nail from the bone, aseptic loosening of the nail in 1 limb, Failure of telescopy in 4 limbs, two limbs nail cut out (revision nailing done). In one patientall 4 long bones of the lower limb were operated in one sitting. No infections wereencountered. Functional weight bearing ambulation was started with support at an average period of 3 months for patients with OI and at 4 months for patients with CPT. All patients had satisfactory range of movement of the joint except in 3 limbs were the nail backed into the joint.

How to Cite this Abstract
Sandesh. Telescopic nail system in children – Our experience. International Journal of Conference Proceedings. March 2015;(2015):10.