Skip to main content

Advertisement

SpringerLink
Log in

Modified Sofield-Millar operation: less invasive surgery of lower limbs in osteogenesis imperfecta

  • Original Paper
  • Published:
International Orthopaedics Aims and scope Submit manuscript

Abstract

We present the results of intramedullary rodding of long bones of the lower limbs in children with osteogenesis imperfecta using a modified Sofield-Millar operation. Fourteen patients (mean age at primary operation was 5 years 11 months) were treated with a modified Sofield-Millar operation which allows minimal bone exposure, preservation of the periosteum and keeping the number of osteotomies to the minimum. Union was achieved in all cases within 7 weeks. Of the 14 patients (29 bones) treated with nonelongating rods, rod revisions were needed in 13 patients (26 bones). We found no statistically significant difference between the width of the bone immediately postoperatively and at the final follow-up. The walking ability was improved in four patients. Advantages of less invasive surgery in osteogenesis imperfecta are rapid bone union, no bone atrophy or nonunion, better postoperative mobility and small scars.

Résumé

L’objectif de cette étude est d’évaluer les résultats du brochage intra médullaire des os longs des membres inférieurs chez les enfants présentant une ostéogénèse imparfaite en utilisant la technique modifiée de Sofield-Millar. Matériel et méthode : 14 patients (âge moyen à la première intervention 5 ans) ont été traités avec cette méthode de Sofield-Millar modifiée qui permet, à partir d’un abord minimal de préserver le périoste; de réduire au minimum le nombre d’ostéotomies. Résultats, une consolidation a été obtenue dans tous les cas au bout de sept semaines. 14 patients (29 segments osseux) ont été traités avec un clou ne permettant pas la croissance, la révision du clou a été nécessaire chez 13 patients (26 segments osseux). Nous n’avons pas trouvé de différences significatives sur la qualité osseuse en post-op immédiat et au suivi final. La marche a été améliorée chez 4 patients. En conclusion : cette technique moins invasive est avantageuse dans le traitement de l’ostéogénèse imparfaite et permet une consolidation rapide sans atrophie osseuse et sans pseudarthrose avec une bonne mobilité post-opératoire et des cicatrices minimes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Agarwal V, Joseph B (2005) Non-union in osteogenesis imperfecta. J Pediatr Orthop B 14(6):451–455

    PubMed  Google Scholar 

  2. Bailey WR, Dubow HI (1981) Evolution of the concept of an extensible nail accommodating to normal longitudinal bone growth: clinical considerations and implications. Clin Orthop 159:157–170

    PubMed  Google Scholar 

  3. Cole WG (1993) Early surgical management of severe forms of osteogenesis imperfecta. Am J Med Genet 45:270–274

    Article  PubMed  CAS  Google Scholar 

  4. Daly K, Wisbeach A, Sanpera I, Fixsen JA (1996) The prognosis for walking in osteogenesis imperfecta. J Bone Joint Surg Br 78:477–480

    PubMed  CAS  Google Scholar 

  5. Engelbert RH, Uiterwaal CS, Gerver WJ, van der Net JJ, Pruijs HE, Helders PJ (2004) Osteogenesis imperfecta in childhood: impairment and disability. A prospective study with 4-year follow-up. Arch Phys Med Rehabil 85(5):772–778

    Article  PubMed  Google Scholar 

  6. Fassier F, Duval P (2001) New concept for telescoping rodding in osteogenesis imperfecta: preliminary results. Annual Meeting of Pediatric Orthopaedic Society of North America, Cancun, Mexico, p 101

  7. Gamble JG, Strudwick WJ, Rinsky LA, Bleck EE (1988) Complications of intramedullary rods in osteogenesis: Bailey-Dubow rods versus non-elongating rods. J Pediatr Orthop 8:645–649

    PubMed  CAS  Google Scholar 

  8. Joseph B, Rebello G, Chandra KB (2005) The choice of intramedullary devices for the femur and the tibia in osteogenesis imperfecta. J Pediatr Orthop B 14(5):311–319

    PubMed  Google Scholar 

  9. Lang-Stevenson AI, Sharrard WJW (1984) Intramedullary rodding with Bailey-Dubow extensible rods in osteogenesis imperfecta: an interim report of results and complications. J Bone Joint Surg Br 66:227–232

    PubMed  CAS  Google Scholar 

  10. Li YH, Chow W, Leong JC (2000) The Sofield-Millar operation in osteogenesis imperfecta. A modified technique. J Bone Joint Surg Br 82(1):11–16

    Article  PubMed  CAS  Google Scholar 

  11. McHale KA, Tenuta JJ, Tosi LL, McKay DW (1994) Percutaneous intramedullary rodding of long bone deformity in severe osteogenesis imperfecta. Clin Orthop 305:242–248

    PubMed  Google Scholar 

  12. Middleton RWD (1984) Closed intramedullary rodding for osteogenesis imperfecta. J Bone Joint Surg Br 66:652–655

    PubMed  CAS  Google Scholar 

  13. Mulpuri K, Joseph B (2000) Intramedullary rodding in osteogenesis imperfecta. J Pediatr Orthop 20:267–273

    Article  PubMed  CAS  Google Scholar 

  14. Plotkin H (2006) Two questions about osteogenesis imperfecta. J Pediatr Orthop 26(1):148–149

    Article  PubMed  Google Scholar 

  15. Porat S, Heller E, Seidman DS, Meyer S (1991) Functional results of operation in osteogenesis imperfecta: elongating and nonelongating rods. J Pediatr Orthop 11:200–203

    PubMed  CAS  Google Scholar 

  16. Ryöppy S, Alberty A, Kaitila I (1987) Early semiclosed stabilization in osteogenesis imperfecta. J Pediatr Orthop 7:139–144

    PubMed  Google Scholar 

  17. Sillence DO (1981) Osteogenesis imperfecta: an expanding panorama of variants. Clin Orthop 159:11–25

    PubMed  Google Scholar 

  18. Sofield HA, Millar EA (1959) Fragmentation, realignment, and intramedullary rod fixation of deformities of the long bones in children. J Bone Joint Surg Am 41:1371–1391

    Google Scholar 

  19. Herring JA (2002) Osteogenesis imperfecta. In: Tachdjian’s Pediatric Orthopaedics, 3rd edn. Saunders, Philadelphia, pp 1717–1743

  20. Tiley F, Albright JA (1973) Osteogenesis imperfecta: treatment by multiple osteotomy and intramedullary rod insertion: report on 13 patients. J Bone Joint Surg Am 55:701–713

    PubMed  CAS  Google Scholar 

  21. Wilkinson JM, Scott BW, Clarke AM, Bell MJ (1998) Surgical stabilisation of lower limbs in osteogenesis imperfecta using the Sheffield Telescopic Intramedullary Rod System. J Bone Joint Surg Br 80:999–1004

    Article  CAS  Google Scholar 

  22. Wilkinson JM, Scott BW, Bell MJ (1997) The prognosis for walking in osteogenesis imperfecta (letter to editor). J Bone Joint Surg Br 79(2):339

    Article  PubMed  CAS  Google Scholar 

  23. Zionts LE, Ebramzadeh E, Stott NS (1998) Complications in the use of the Bailey-Dubow extensible nail. Clin Orthop 348:186–195

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Orthopedic Department, Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt

    Mazen Abulsaad

  2. Radiology Department, Mansoura University Hospital, Mansoura, Egypt

    Ashraf Abdelrahman

Authors
  1. Mazen Abulsaad
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ashraf Abdelrahman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mazen Abulsaad.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Abulsaad, M., Abdelrahman, A. Modified Sofield-Millar operation: less invasive surgery of lower limbs in osteogenesis imperfecta. International Orthopaedics (SICOT) 33, 527–532 (2009). https://doi.org/10.1007/s00264-008-0515-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00264-008-0515-1

Keywords

Search

Navigation