Tuesday 9 January 2018

Rodding in patients with Osteogenesis





Dr Fizza Hassan is a Final Year Student at Karachi Medical and Dental College, affiliated with Karachi University. She has been a keen researcher since High School and took part in many scientific projects at city level. She has attended several national and international seminars and conferences. She has taken part in many researches successfully published in international journals and many are ongoing. She is looking forward to a bright future in medical career. Being an speaker at World Congress on Rheumatology & Orthopedics Conference held by Scientific Federation. Dr. Fizza Hassan is going to talk on “Prognosis of Functional Capability after Telescopic Femoral Intramedullary Rodding in patients with Osteogenesis Imperfecta type IV.” A brief summary is presented here.
Osteogenesis imperfecta is a group of genetic bone disorder of significant clinical variability secondary to mutations in the genes that code for type I pro-collagen. Major clinical characteristics of OI are bone fragility, osteopenia, variable degrees of short stature, and progressive skeletal deformities.The severity of the disease influences the ability to walk. Therefore it is important for physicians, patients, and the patients’ parents to gain insight into the severity and classification of the disease and the influence of disease-related characteristics on the prognosis for walking. Intramedullary strengthening of the fragile bones of Osteogenesis imperfecta by rodding results in great benefit on the affected individual. Rodding is an sign of disease severity. In general, intramedullary rodding in the lower extremities is primarily indicated in the most severe types to stabilize bone and to correct deformities. Early closed rodding has improved the early management of the disease without causing and ill effects. Because no randomized clinical trials have been performed for ethical reasons, the improvement of possibilities for ambulation after intramedullary rodding of the lower extremities remain questionable. Several authors state that intramedullary rodding of the legs improved the possibility for ambulation and expanding intramedullary rods reduce incidence of deformity, fractures, and increase walking capability, whereas others found no differences in patients who did and did not receive intramedullary rodding in the age of first achieving motor milestones and the ability for walking in later life. After intramedullary rodding of the legs was performed, functional ability, especially in the preexisting milestones, improved in patients with type III and IV, whereas in patients with type I, walking ability improved.
It has been reported that in type IV, even when ambulation is achieved, walking is frequently lost in the second decade of life because of progressive spinal deformity, decreased motivation in physical therapy and the increasing use of a wheelchair

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