Osteogenesis imperfecta in Zimbabwe: a comparison between treatment with intramedullary rods of fixed-length and self-expanding rods.

The results of surgical treatment of 15 children with osteogenesis imperfecta in Bulawayo, Zimbabwe are reviewed. A total of 23 self-expanding and 27 fixed-length rods were used. Outcome was measured in terms of mobility status, growth, incidence of refracture, need for reoperation, and complications. Eight of the children improved their mobility status over the course of treatment. Self-expanding rods appeared to confer more benefit to growth than fixed-length rods. Refracture was more common in bones splinted with fixed-length rods and more often necessitated revision surgery in these bones. The complication rate was high in all cases, but the complications associated with outgrown fixed-length rods were a particular problem. The 15 children benefited from surgical treatment. The self-expanding rods performed better than fixed-length rods in reducing the number of surgical interventions. They also appear to facilitate growth. The self-expanding rods may be used to good effect in appropriate centres in the developing world.