Orthopaedic complications and iatrogenies during deformity correction of lower limbs in patients with severe osteogenesis imperfecta

Abstract

An incidence and severity of adverse effects of postoperative care of patients with osteogenesis imperfecta (OI), the treatment and outcomes are essential elements for the study of the nosologic group in addition to clinical review of surgical outcomes. Purpose was to examine complications of surgical orthopaedic treatment, reconstructive procedures and follow-up period of patients with OI types III and IV. Material and methods The study included 43 patients aged 33 months to 46 years (14.4 ± 9.74 years). Clinical and radiological features of OI types III and IV were observed in 14 and 29 cases, correspondingly. To analyse the complications the patients were subdivided into three groups depending on the technique applied and patients’ age. Group I was composed of skeletally mature patients aged 16 years and older with radiological physeal closure who underwent combined osteosynthesis of elastic intramedullary nailing and Ilizarov external fixation of lower limbs. Group II included skeletally immature patients aged less than 16 years with radiologically visible physis who underwent combined osteosynthesis of elastic intramedullary nailing and Ilizarov external fixation of lower limbs. Group III included skeletally immature patients aged less than 16 years with radiologically visible physis who underwent elastic intramedullary nailing alone. Results From a variety of techniques used to correct lower limb deformity in patients with severe OI the combination of elastic intramedullary nailing and Ilizarov external fixation with acute multi-level deformity correction of lower limbs was shown to be most efficacious in children and adults due to lower risk of complications associated with surgical treatment, osteosynthesis and the condition.