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Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta

(1) Background: The Fassier–Duval (FD) nail was developed for the treatment of osteogenesis imperfecta (OI). The aim of this study was to review the results of OI patients treated with the FD nail at our institution and discuss a surgical strategy to decrease the FD nail revision rate; (2) Methods:...

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Autores principales: Hung, Yi-Chi, Cheng, Kai-Yuan, Lin, Hsiang-Yu, Lin, Shuan-Pei, Yang, Chen-Yu, Liu, Shih-Chia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323302/
https://www.ncbi.nlm.nih.gov/pubmed/35887648
http://dx.doi.org/10.3390/jpm12071151
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author Hung, Yi-Chi
Cheng, Kai-Yuan
Lin, Hsiang-Yu
Lin, Shuan-Pei
Yang, Chen-Yu
Liu, Shih-Chia
author_facet Hung, Yi-Chi
Cheng, Kai-Yuan
Lin, Hsiang-Yu
Lin, Shuan-Pei
Yang, Chen-Yu
Liu, Shih-Chia
author_sort Hung, Yi-Chi
collection PubMed
description (1) Background: The Fassier–Duval (FD) nail was developed for the treatment of osteogenesis imperfecta (OI). The aim of this study was to review the results of OI patients treated with the FD nail at our institution and discuss a surgical strategy to decrease the FD nail revision rate; (2) Methods: We retrospectively reviewed OI patients treated at our institution between 2015 and 2020. OI patients treated with FD nail insertion in the long bones of the lower extremities were included, and those with a follow-up duration <1 year or incomplete radiographs were excluded. Data on the type of OI, age, sex, use of bisphosphonate treatment, and nail failure were recorded; (3) Results: The final cohort consisted of seven patients (three females and four males) with ten femurs and ten tibiae involved. Six of the patients had type III OI, and one had type IV OI. An exchange of implant was required in 11 limbs. The average interval between previous FD nail insertion and revision surgery was 2.4 years; (4) Discussion: The main reasons for revision surgery were migration of the male/female component, refracture/nail bending, and delayed union. In the femur, migration of the female component or nail bending were common reasons for failure, while migration of the male component and delayed union were common in the tibia; (5) Conclusions: Surgery for OI patients is challenging, and physicians should aim to minimize complications and the need for revision. Sufficient depth of purchase, center–center nail position, and adequate osteotomy to correct bowing are the key factors when using the FD nail.
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spelling pubmed-93233022022-07-27 Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta Hung, Yi-Chi Cheng, Kai-Yuan Lin, Hsiang-Yu Lin, Shuan-Pei Yang, Chen-Yu Liu, Shih-Chia J Pers Med Article (1) Background: The Fassier–Duval (FD) nail was developed for the treatment of osteogenesis imperfecta (OI). The aim of this study was to review the results of OI patients treated with the FD nail at our institution and discuss a surgical strategy to decrease the FD nail revision rate; (2) Methods: We retrospectively reviewed OI patients treated at our institution between 2015 and 2020. OI patients treated with FD nail insertion in the long bones of the lower extremities were included, and those with a follow-up duration <1 year or incomplete radiographs were excluded. Data on the type of OI, age, sex, use of bisphosphonate treatment, and nail failure were recorded; (3) Results: The final cohort consisted of seven patients (three females and four males) with ten femurs and ten tibiae involved. Six of the patients had type III OI, and one had type IV OI. An exchange of implant was required in 11 limbs. The average interval between previous FD nail insertion and revision surgery was 2.4 years; (4) Discussion: The main reasons for revision surgery were migration of the male/female component, refracture/nail bending, and delayed union. In the femur, migration of the female component or nail bending were common reasons for failure, while migration of the male component and delayed union were common in the tibia; (5) Conclusions: Surgery for OI patients is challenging, and physicians should aim to minimize complications and the need for revision. Sufficient depth of purchase, center–center nail position, and adequate osteotomy to correct bowing are the key factors when using the FD nail. MDPI 2022-07-15 /pmc/articles/PMC9323302/ /pubmed/35887648 http://dx.doi.org/10.3390/jpm12071151 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hung, Yi-Chi
Cheng, Kai-Yuan
Lin, Hsiang-Yu
Lin, Shuan-Pei
Yang, Chen-Yu
Liu, Shih-Chia
Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta
title Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta
title_full Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta
title_fullStr Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta
title_full_unstemmed Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta
title_short Surgical Strategy to Decrease the Revision Rate of Fassier–Duval Nailing in the Lower Limbs of Osteogenesis Imperfecta
title_sort surgical strategy to decrease the revision rate of fassier–duval nailing in the lower limbs of osteogenesis imperfecta
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9323302/
https://www.ncbi.nlm.nih.gov/pubmed/35887648
http://dx.doi.org/10.3390/jpm12071151
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