Efficacy of Corkscrew-Tipped Telescopic Nail in the Management of Osteogenesis Imperfecta in Pediatric Patients

Abstract

Background: Telescopic intramedullary nailing is a cornerstone in the surgical management of pediatric osteogenesis imperfecta (OI), providing fracture prevention and deformity correction while accommodating bone growth. Nevertheless, implant-related complications remain a challenge affecting long-term outcomes. Methods: This retrospective single-center study evaluated 13 pediatric patients with OI who underwent femoral fixation using corkscrew-tipped telescopic nails (CTTN) between 2014 and 2021. Demographic characteristics, Sillence classification, surgical indications, radiological outcomes, rod migration, complication, and revision rates were analyzed. Implant survival was assessed using Kaplan-Meier analysis. Results: The study consisted of 7 female (53.8%) and 6 male (46.2%) patients, with a mean age of 9.2 ± 3.8 years. Most patients were classified as Sillence type IB (84.6%), with one patient each classified as Type IA and Type III. Rod migration occurred in three patients (23.0%) without distal joint penetration. Limited telescoping was observed in two femurs (15.2%). The revision rate was 23.0%, and the overall complication rate was 38.4%. Mean rod survival was 4.8 years (95% confidence interval [CI], 3.9-5.7). Conclusion: CTTNs appear to be a feasible option for femoral fixation in pediatric patients with OI, avoiding joint arthrotomy and demonstrating acceptable complication and revision rates. However, lateral rod migration remains a notable limitation, indicating that adjunct stabilization techniques may be required.