Abstract
This is a case of a 13-year-old girl with Type VIII osteogenesis imperfecta (OI), who required care for femur nonunion and problems with the Fassier-Duval (FD) rod and other local hardware. A revision surgery featuring hardware removal and fixation with intramedullary pins and an external fixator was successful in achieving anatomic union.
Telescopic rodding is recognized as the most successful system for long-lasting intramedullary osteosynthesis dedicated to correction of long bone deformities in children with OI. The major limitation of any intramedullary telescopic system is rotational and longitudinal instability. The combined use of telescopic rods and locking plates with screw fixation is aimed to prevent secondary torsional deformations. However, this method does not enable axial loading on the operated site of the bone. It mandates a second operation to remove the plate after bone union. This combined approach also excludes the possibility of minimally invasive percutaneous osteotomies. Further, the proximity of dissimilar metals may lead to galvanic reaction injuring tissues and compromising hardware. It is well-known, the common metallurgic wisdom cautions against association of dissimilar metals for osteosynthesis in a biologically active environment. This impermissible situation results in corrosion that compromises the implants and leads to aseptic loosening, implant failure, or adverse biological reaction, e.g., aseptic inflammation, in host tissue.
References and Suggested Reading
Eliaz N. Corrosion of metallic biomaterials: a review. Materials (Basel). 2019;12(3):407.
Franzone JM, Kruse RW. Nailing with supplemental plate and screw fixation of long bones of patients with osteogenesis imperfecta: operative technique and preliminary results. J Pediatr Orthop B. 2018;27(4):344–9.
Popkov D, Dolganova T, Mingazov E, Dolganov D, Kobyzev A. Combined technique of titanium telescopic rods and external fixation in osteogenesis imperfecta patients: first 12 consecutive cases. J Orthop. 2020;22:316–25.
Popkov D. Use of flexible intramedullary nailing in combination with an external fixator for a postoperative defect and pseudarthrosis of femur in a girl with osteogenesis imperfecta type VIII: a case report. Strateg Trauma Limb Reconstr. 2018;13(3):191–7.
Zartman KC, Berlet GC, Hyer CF, Woodard JR. Combining dissimilar metals in orthopaedic implants: revisited. Foot Ankle Spec. 2011;4(5):318–23.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2024 Springer Nature Switzerland AG
About this entry
Cite this entry
Popkov, D., Lascombes, P. (2024). Revision of Telesco** Rod and Plate Complicated with Nonunion and Metallosis in a Girl with Osteogenesis Imperfecta Type VIII. In: Rozbruch, S.R., Hamdy, R. (eds) Limb Lengthening and Reconstruction Surgery Case Atlas. Springer, Cham. https://doi.org/10.1007/978-3-319-02767-8_417-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-02767-8_417-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-02767-8
Online ISBN: 978-3-319-02767-8
eBook Packages: Springer Reference MedicineReference Module Medicine