Telescoping Nail in Osteogenesis Imperfecta

Osteogenesis Imperfecta (OI) is an autosomal dominant disorder that mainly affects the bones. Bones break easily. The severity may be mild to severe. OI includes a blue tinge to the sclera of the eye, short height, loose joints, hearing loss, breathing problems and problems with the teeth. Complications may include cervical and aortic artery dissection. Telescoping Nail Osteosynthesis: The necessity for such treatment is given by the rapidly evolving anterior bowing (sometimes associated with rotation) and the increasing incidence of bone fracturing after cast removal. The decision to choose Sheffield-Millard osteotomies is based on the more than 20° angulation and the narrow medullar channel that makes reaming the only solution for passing the rod. Sometimes, in very severe cases, when the distance between the epiphysis gets smaller as the bone gets more and more bowed, it is imperative to do a shorting of the segment so that the soft tissues are not put in excessive tension after alignment. Until the development of this technique, doctors used Kirschnerwire ,Kuntscher nails , Rush nails , Ender nails and most recently, elastic nailing . All the techniques had good short-term results, with good bone alignment and prevention of the refracturing of the bone. However, the biggest problem with these materials was that the patients outgrew them very fast, and problems like secondary bowing and refracturing appeared. The aim of this study is the evaluation of the management of skeletal deformities in growing children with OI with telescoping nails. This cross-sectional study was conducted. Twenty patients were included in this study operated at Alazhar University Hospital Assuit. The duration of the study ranged from 24-36 months.