Bilateral Lower Limb Deformity Correction in Osteogenesis Imperfecta Using a Non-elongating Rush Rod: A Pragmatic Approach.

Osteogenesis imperfecta is a genetic disorder caused by defects in type I collagen. Long-bone plastic bowing results from bone fragility, microfractures, deforming muscular forces, stress fractures, and malunion. The primary goal of treatment is deformity correction and stabilization to prevent recurrent fractures and progression. The management of long-bone deformities commonly involves corrective osteotomies with intramedullary stabilization. Although telescopic rods are widely preferred for their ability to accommodate skeletal growth, their availability and cost may limit their use in many centers. Therefore, we present a report of the management of severe bilateral femoral and tibial deformities in a child with osteogenesis imperfecta using non-telescopic Rush rods. A five-year-old boy presented with progressive deformities of the upper and lower limbs associated with an inability to walk independently following multiple fractures after trivial trauma. Clinical examination revealed blue sclerae, dentinogenesis imperfecta, short stature, thoracic kyphoscoliosis, and marked bowing deformities of the femur and tibia. Staged operative correction of bilateral lower limb deformities was performed. Multiple osteotomies were conducted at the apex of the deformities, followed by intramedullary stabilization of the femur and tibia using Rush rods. Postoperatively, hip spica immobilization was maintained for six weeks after each procedure, followed by gradual rehabilitation and radiographic monitoring. One instance of implant migration was noted during follow-up and addressed during the subsequent procedure. At one-year follow-up after the completion of staged correction, the patient was able to ambulate independently with maintained alignment, healed osteotomy sites, and satisfactory functional recovery. This case demonstrates that non-telescopic Rush rod fixation remains a useful option for deformity correction in osteogenesis imperfecta when telescopic systems are unavailable or technically unsuitable, and it highlights the surgical technique using Rush rod. Despite limitations related to skeletal growth and implant-related complications, satisfactory alignment and restoration of ambulation can be achieved with careful planning, meticulous surgical technique, and close follow-up.