SURVIVAL RATES OF THE HIMEX EXTENSIBLE NAIL IN THE TREATMENT OF CHILDREN WITH OSTEOGENESIS IMPERFECTA

Objective To evaluate the performance of an extensible nail with hooks named HIMEX in osteogenesis imperfecta (OI) deformities Methods All child patients were operated on with HIMEX from 1990 to 2004 The number of fractures reappearance of deformities improvement of motor development before and after the use of HIMEX and the incidence of the migration and nail survival were compared Results Fourteen patients with ages from 2 to 18 years including 8 females underwent 46 procedures 39 primary and 7 re operations The average age at the first fracture was 148 21 days and there was an average of 42 6 fractures per patient prior to HIMEX placement Of the forty six bones affected 28 were femurs and 18 were tibias Average follow up care lasted 80 21 +/- 36 71 months There was a statistically significant decrease (0 78) in the number of fractures per patient and an improvement in walking in seven of the fourteen patients Revision occurred in 18% of patients and migration of the nail occurred in 12% (5/39) Eighty percent of the nails remained in situ until 108 months with femoral procedures lasting significantly longer than tibial procedures The type of OI and the age at the procedure did not significantly affect the incidence of revision Conclusion HIMEX significantly reduced the number of fractures presenting lower incidence of migration and higher survival rates than those described in literature