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Peer-reviewedCC BY-NCJournal of children's orthopaedics

Tips and tricks for femoral Fassier-Duval rod revision in osteogenesis imperfecta.

  • Pasin Tangadulrat1,2
  • Reggie Charles Hamdy2
  1. 1Department of Orthopedics, Faculty of Medicine, Prince of Songkla University, Hatyai, Songkhla, Thailand.
  2. 2Pediatrics and Limb Deformity Unit, Department of Pediatric Orthopaedic Surgery, McGill University, Shriners Hospital for Children, Montreal, QC, Canada.
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Abstract

Purpose

Osteogenesis Imperfecta (OI) is characterized by severe bone fragility, requiring intramedullary telescopic rodding such as the Fassier-Duval (FD) rod to correct and prevent progressive deformities. Although the FD rod is widely used, the revision rates, especially in the femur, remain high. This study aims to evaluate a structured decision-making framework and detailed surgical techniques for FD femoral revision in OI.Methods

We retrospectively reviewed a cohort of 76 limbs from 37 patients with OI who underwent surgery between 2020 and 2024. A specific sub-cohort of 21 femoral FD revisions was evaluated to establish baseline failure characteristics. Within this group, a sample of 9 patients (10 limbs) was reviewed in detail to analyze specific technical strategies and mid-term clinical outcomes.Results

Among 21 femoral revision limbs evaluated at a median follow-up of 28 months (range, 12 - 42 months), union was achieved in 89.5% of indicated cases (17/19) at a median of 16 weeks (range, 12-28 weeks). Postoperative complications occurred in 6 of 21 limbs (28.6%), of which three were managed nonoperatively, and three (14.3%) required secondary re-revision including refracture with rod bending, distal pull-out, and symptomatic nonunion. Overall, 18 limbs maintained functional hardware in situ, yielding an 85.0% FD rod survival rate (17/20 limbs) at a median of approximately two years post-revision.Conclusion

Femoral FD rod revision requires a tailored approach for each patient. Using a systematic decision-making flowchart, combined with meticulous surgical techniques, could help reduce the potential lifetime burden of surgery and provide reliable mid-term implant survival.

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Cite

BibTeXRIS
BibTeX
@article{tangadulrat2026tips,
  title = {{Tips and tricks for femoral Fassier-Duval rod revision in osteogenesis imperfecta.}},
  author = {Pasin Tangadulrat and Reggie Charles Hamdy},
  journal = {Journal of children's orthopaedics},
  year = {2026},
  month = oct,
  doi = {10.1177/18632521261500899},
  url = {https://europepmc.org/article/MED/42926769},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Tips and tricks for femoral Fassier-Duval rod revision in osteogenesis imperfecta.
AU  - Pasin Tangadulrat
AU  - Reggie Charles Hamdy
PY  - 2026
DA  - 2026/10/23
JO  - Journal of children's orthopaedics
DO  - 10.1177/18632521261500899
UR  - https://europepmc.org/article/MED/42926769
AB  - Purpose  Osteogenesis Imperfecta (OI) is characterized by severe bone fragility, requiring intramedullary telescopic rodding such as the Fassier-Duval (FD) rod to correct and prevent progressive deformities. Although the FD rod is widely used, the revision rates, especially in the femur, remain high. This study aims to evaluate a structured decision-making framework and detailed surgical techniques for FD femoral revision in OI.Methods  We retrospectively reviewed a cohort of 76 limbs from 37 patients with OI who underwent surgery between 2020 and 2024. A specific sub-cohort of 21 femoral FD revisions was evaluated to establish baseline failure characteristics. Within this group, a sample of 9 patients (10 limbs) was reviewed in detail to analyze specific technical strategies and mid-term clinical outcomes.Results  Among 21 femoral revision limbs evaluated at a median follow-up of 28 months (range, 12 - 42 months), union was achieved in 89.5% of indicated cases (17/19) at a median of 16 weeks (range, 12-28 weeks). Postoperative complications occurred in 6 of 21 limbs (28.6%), of which three were managed nonoperatively, and three (14.3%) required secondary re-revision including refracture with rod bending, distal pull-out, and symptomatic nonunion. Overall, 18 limbs maintained functional hardware in situ, yielding an 85.0% FD rod survival rate (17/20 limbs) at a median of approximately two years post-revision.Conclusion  Femoral FD rod revision requires a tailored approach for each patient. Using a systematic decision-making flowchart, combined with meticulous surgical techniques, could help reduce the potential lifetime burden of surgery and provide reliable mid-term implant survival.
SN  - 1863-2521
SN  - 1863-2548
ER  -