Clinical and Functional Outcomes of Telescoping Intramedullary Nails in Pediatric Osteogenesis Imperfecta: A Multicenter Prospective Study With a One-Year Follow-Up.

BACKGROUND

Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by bone fragility and deformities, often necessitating surgical management in children.

OBJECTIVE

To evaluate clinical and radiological outcomes, complication rates, and functional improvements after telescoping nail fixation for long bone fractures and deformities in pediatric patients with OI.

METHODOLOGY: This prospective, multicenter observational study was conducted at the Mardan Medical Complex, Mardan, and Gajju Khan Medical College, Swabi, from November 2021 to April 2024. A total of 78 pediatric patients with OI who had their long bones fixed or their deformities corrected with telescoping nails (Fassier-Duval or Sheffield) were included. At six weeks, three months, six months, and 12 months, we documented both radiological evaluations (fracture union, deformity correction, nail telescoping) and functional outcomes (Pediatric Outcomes Data Collection Instrument [PODCI] and Functional Mobility Scale [FMS]). We used SPSS v26.0 (IBM Corp., Armonk, NY, USA) to look at the data, and we set the level of significance at p < 0.05.

RESULTS

Out of 78 patients (46 males, 32 females), fracture union was achieved in 76 patients (97.44%) and deformity correction in 71 patients (91.03%) by 12 months. Nail telescoping was observed in 66 patients (84.62%). Functional scores showed significant improvement: mean PODCI increased from 42.35 ± 6.21 to 78.94 ± 7.18, and FMS at 5 meters from 1.98 ± 0.66 to 4.01 ± 0.56 (both p < 0.001). Postoperative complications occurred in 18 patients (23.08%), with refracture (6.41%) and implant migration/failure (5.13%) being the most frequent.

CONCLUSION

Telescoping nails offer a safe and effective solution for long bone stabilization in children with OI, promoting sustained union and functional gains.