Results and survival of Fassier-Duval rods in children with moderate Osteogenesis Imperfecta: a retrospective study in 36 cases

Introduction: Intramedullary rodding for long bone alignment in children with osteogenesis imperfecta (OI) improves mobility and reduces fracture frequency. However, complications and revision surgeries are common. Objectives: To describe outcomes, complications, and factors influencing implant survival in children with moderate OI whose lower limbs were aligned using Fassier-Duval (FD) rods, in a pediatric hospital. Methods: Retrospective analytical analysis of clinical records and X-rays of children with >1 year of postoperative follow-up. Clinical variables, treatment details, complications, and implant failure were registered. Descriptive and inferential statistics were performed. Results: A total of 101 FD rods were evaluated in 36 patients. The median ages at initial FD rodding and revision surgery were 5.3 and 9.4 years, respectively (wide ranges observed). Indications for treatment included previous implant replacement (48.5%), deformity correction (37.6%), and fracture management (13.9%). Mechanical complications occurred in 35.6% of FD rods, primarily due to fixation failure, with 24.8% requiring revision or replacement. A history of prior alignment was associated with improved implant survival, whereas younger surgical age and longer follow-up were associated with implant failure. Implant survival was higher in ambulatory patients and those receiving anti-resorptive therapy. Postoperatively, fracture frequency and deformity decreased, while ambulatory capacity was maintained. This retrospective study conducted at a single center did not allow confirmation of some findings of interest. Conclusions: Our findings align with existing literature. Implant survival was influenced by multiple factors, highlighting the need for a multidisciplinary approach. As not all patients reached skeletal maturity, some outcomes require longer-term follow-up.