Bacaksiz Tayfun, Akan Ihsan
Department of Orthopedics and Traumatology, Izmir Katip Celebi University Ataturk Training and Research Hospital, Izmir, TUR.
Cureus. 2023 Sep 16;15(9):e45376. doi: 10.7759/cureus.45376. eCollection 2023 Sep.
Introduction The treatment of musculoskeletal pathologies in osteogenesis imperfecta aims to provide the maximum possible function by preventing bone fractures and progressive deformities. Despite the development of implants used in the surgical treatment of osteogenesis imperfecta, there is no consensus on the most appropriate method for the correction of skeletal deformities. The aim of this study was to compare telescopic and non-telescopic implants in terms of postoperative complications. Methods Twenty-three patients who were operated on for the diagnosis of osteogenesis imperfecta between 2005 and 2018 were retrospectively analyzed. Demographic data, follow-up times, and the total number of surgeries and complications were recorded. The operated bones were divided into two groups according to whether the intramedullary fixation material used was telescopic or not. Results Twenty-one of 23 patients were included in the study due to the use of intramedullary fixation material in the operation. The mean age was 10.1 ± 2.9 years, and the mean follow-up period was 8.9 ± 3.5 years. Intramedullary fixation was applied to 43 long bones in 21 patients due to fracture or deformity. At least one complication was encountered in nine of 14 bones with telescopic implants and in 27 of 29 bones with non-telescopic implants. Major complications requiring surgical treatment were seen in seven bones of the telescopic implant group and 27 bones of the non-telescopic implant group. Conclusion The use of telescopic implants relatively reduces the complication rate and the need for repetitive surgery in patients with a diagnosis of osteogenesis imperfecta. However, the number of complications is still as high as with non-telescopic implants.
成骨不全症中肌肉骨骼病变的治疗旨在通过预防骨折和渐进性畸形来提供尽可能大的功能。尽管用于成骨不全症外科治疗的植入物有所发展,但对于骨骼畸形矫正的最合适方法尚无共识。本研究的目的是比较伸缩式和非伸缩式植入物在术后并发症方面的情况。方法:对2005年至2018年间因成骨不全症诊断而接受手术的23例患者进行回顾性分析。记录人口统计学数据、随访时间、手术总数和并发症情况。根据所使用的髓内固定材料是否为伸缩式,将手术的骨骼分为两组。结果:23例患者中有21例因手术中使用了髓内固定材料而纳入研究。平均年龄为10.1±2.9岁,平均随访期为8.9±3.5年。由于骨折或畸形,对21例患者的43根长骨进行了髓内固定。在使用伸缩式植入物的14根骨头中有9根至少出现了一种并发症,在使用非伸缩式植入物的29根骨头中有27根出现了并发症。伸缩式植入物组有7根骨头出现了需要手术治疗的主要并发症,非伸缩式植入物组有27根骨头出现了此类并发症。结论:对于诊断为成骨不全症的患者,使用伸缩式植入物相对降低了并发症发生率和重复手术的必要性。然而,并发症的数量仍然与非伸缩式植入物一样高。