Surgical Technique for Revision of the Distally Migrated Fassier-Duval Femoral Rod in Osteogenesis Imperfecta: A Case Report.

Background/

Objectives

Managing long bone fractures and deformities in osteogenesis imperfecta (OI) with telescoping rods is a common but challenging procedure. A rare complication is the distal migration of the rod's proximal female component, which complicates standard revision surgery. This article aims to describe a surgical technique for the revision of a distally migrated Fassier-Duval (FD) femoral rod.

Methods

We present the case of an 8-year-old girl with OI type IV who experienced distal migration of her right femoral FD rod-the surgical technique involved extracting the rod retrogradely through the fracture/osteotomy site. We used a trephine to remove surrounding bone within the canal, thereby preserving the critical bone stock in the greater trochanter needed for secure fixation of the revision implant.

Results

The distally migrated female component was successfully removed through the trephined canal with a combination of axial traction and rotational force. The proximal bone stock was preserved, allowing for the stable placement of a revision FD rod.

Conclusions

The retrograde trephine technique is a viable and effective strategy for revising a distally migrated telescoping rod in patients with OI. This approach prioritizes the preservation of proximal bone stock, which is crucial for the stability and longevity of the revision implant.