This single-center retrospective study compared implant survival between Fassier-Duval telescoping rods and static implants (Rush rods, flexible nails, Steinmann pins) in 64 surgically naive lower extremity limbs of children with osteogenesis imperfecta. Cox regression modeled time to implant failure; negative binomial regression quantified total surgical burden over 48 months.
Static intramedullary rods were the original standard for OI fixation, but longitudinal bone growth creates an unsupported segment beyond the rod tip, leading to bending, fracture, and repeated revision operations.
This paper quantifies that gap precisely: children treated with static implants face a 13× higher failure hazard and need surgery 7.8× more often than those treated with FD rods over 4 years.
When you are planning intramedullary fixation in a child with OI, FD rods should be the first-line choice for a surgically naive femur or tibia — not just because survival is better, but because the cumulative surgical burden of static rods is substantial.
Keep in mind that even FD rods fail: pullout is the primary FD failure mode, so watch the proximal and distal screw-bone interface on follow-up films. Girls with OI warrant heightened surveillance regardless of implant. An unexplained 4.8× higher failure hazard in females is a finding the authors flag as needing further study before it changes treatment protocols.
This single-center retrospective study compared implant survival between Fassier-Duval telescoping rods and static implants (Rush rods, flexible nails, Steinmann pins) in 64 surgically naive lower extremity limbs of children with osteogenesis imperfecta. Cox regression modeled time to implant failure; negative binomial regression quantified total surgical burden over 48 months.
Static intramedullary rods were the original standard for OI fixation, but longitudinal bone growth creates an unsupported segment beyond the rod tip, leading to bending, fracture, and repeated revision operations.
This paper quantifies that gap precisely: children treated with static implants face a 13× higher failure hazard and need surgery 7.8× more often than those treated with FD rods over 4 years.
When you are planning intramedullary fixation in a child with OI, FD rods should be the first-line choice for a surgically naive femur or tibia — not just because survival is better, but because the cumulative surgical burden of static rods is substantial.
Keep in mind that even FD rods fail: pullout is the primary FD failure mode, so watch the proximal and distal screw-bone interface on follow-up films. Girls with OI warrant heightened surveillance regardless of implant. An unexplained 4.8× higher failure hazard in females is a finding the authors flag as needing further study before it changes treatment protocols.