Comparative Study of Using Elastic Stable Intramedullary Nail (Esin) Versus Rush Pin in Prophylactic Fixation of Femur & Tibia Fractures Among Children With Osteogenesis Imperfecta Cross-sectional Study

Introduction: Recurrent fractures is the most challenging problem in children with Osteogenesis imperfecta, a variety of surgical methods have been investigated to decrease the incidence of this problem. Objectives: The aim is to compare between the use of Elastic Stable Intramedullary Nail (ESIN) and Rush Pins in order to decrease fracture frequency and asses the complications associated with each method. Methods: A descriptive cross-sectional study was conducted in 40 children with Osteogenesis imperfecta, the age of the participants was between 3 - 16 years. 20 children with OI were operated using ESIN and 20 children with OI were operated using Rush pin. Results: : Both techniques are effective in guarding against fractures and correcting the deformities. The rate of nail proximal migration was relatively higher in the ESIN group. The re-fracture rate was lower in the Rush rod group. The rate of recurrence of angular deformities were slightly higher in the ESIN group. The reoperation rate was higher in the ESIN group. Conclusion: Corrective osteotomy with use of (ESIN) or Rush rods works well in guarding against fractures, but the overall complications and reoperation rate is statistically lower when using Rush rods, however both techniques fail to follow bone growth and have a possible complication such as nail proximal migration, recurrence of deformities and also both techniques do need repeated surgeries. Recommendations: We recommend further studies to assess the outcome between (ESIN, Rush pin) and Telescoping rods, to assess the longevity of these implants and the precise time for exchange and to correlate between surgical interventions with the concomitant use of Bisphosphonates.