Telescoping intramedullary rodding with Bailey-Dubow nails for recurrent pathologic fractures in children without osteogenesis imperfecta

Abstract

We reviewed four children with multiple, recurrent, pathologic fractures caused by bone disease, excluding osteogenesis imperfecta, and in whom multiple osteotomies with telescoping intramedullary stabilization had been performed. The diagnoses were myelomeningocele in two children and Rett syndrome and fibrous dysplasia in one child each. Five long bones were stabilized; four femora and one tibia. The average age at surgery was 6 years 6 months; the average number of fractures that had occurred in the involved bone before surgery was 3.0 per bone. At an average follow-up of 2 years 4 months, the average number of fractures that had occurred after surgery in the stabilized bones was 0.2 per bone. There were no infections, nonunions, or rod complications. We believe that in the carefully selected patient, multiple osteotomies with intramedullary telescoping rod stabilization can be quite successful in solving the problem of recurrent fractures in children with diseases other than osteogenesis imperfecta.