Leg Lengthening in Osteogenesis Imperfecta

Use of intramedullary extending rods in children with osteogenesis imperfecta (OI) can reduce the incidence of further fractures, prevent recurrence of deformity, and allow many children to become independently mobile. Recurrent fractures and epiphyseal injuries that occur before the extending rods are inserted frequently lead to unequal leg lengths. In normal patients, surgical correction of leg length discrepancy is advocated for deformities >3 cm, but these techniques have not been used in OI. Using DeBastiani's method, we successfully lengthened three femoral and one tibial segment in three patients with OI. In two segments, extending intramedullary rods were left in situ and did not affect the lengthening process. In the remaining two segments, the rods were removed before lengthening was performed and were replaced after the regenerate bone was recanalized. Full correction of deformity was achieved, and all patients are now independently mobile. We believe that current limb lengthening techniques can be used in patients with OI.