Using the simple locking intramedullary (SLIM) system for bone deformity stabilization: A retrospective cohort study.

IF 1.6 4区 医学 Q3 ORTHOPEDICS
Journal of Childrens Orthopaedics Pub Date : 2025-07-25 eCollection Date: 2025-10-01 DOI:10.1177/18632521251359105
Peter Joseph Mounsef, Sofia Addab, Saleh Alfaisali, Mitchell Bernstein, Reggie Hamdy
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引用次数: 0

Abstract

Background: Osteogenesis imperfecta (OI) is characterized by bone fragility and deformities. Treating long bone fractures and deformities in OI patients typically involves intramedullary (IM) rods. The Simple Locking Intramedullary (SLIM) nail is a novel surgical device developed to address challenges in patients with narrow medullary canals, which are unsuitable for larger telescoping rods. This study aims to evaluate the outcomes and complications associated with SLIM nail use in pediatric patients with OI.

Methods: A retrospective chart review was conducted at our institution, analyzing 23 patients (41 limbs) who underwent surgery using the SLIM nail between April 2016 and March 2022. Data on patient demographics, surgical intervention, post-operative outcomes, and complications were collected. Radiological evaluations were performed from the immediate post-operative period up to the most recent follow-up.

Results: The SLIM nail demonstrated a 2-year survival rate of 82.8% and a 4-year survival rate of 77.1% in tibial applications. The most common complication was angular deformity in the distal tibia, occurring in 19 patients. Other complications included anterior cortical penetration, nail bending, and one case of nail breakage.

Conclusions: The SLIM nail is a viable option for patients with narrow intramedullary canals, particularly in cases where telescoping rods are not feasible. While the SLIM nail provides adequate stabilization and reduces the need for multiple surgeries, careful monitoring is essential to manage complications such as distal angular deformity. Early revision to a larger rod, when possible, is recommended to prevent further complications as the patient grows.

Level of evidence: Level IV.

使用简单锁定髓内(SLIM)系统稳定骨畸形:一项回顾性队列研究。
背景:成骨不全症(Osteogenesis imperfecta, OI)以骨脆性和骨畸形为特征。治疗成骨不全患者的长骨骨折和畸形通常涉及髓内棒(IM)。简单锁定髓内钉(SLIM)是一种新型的手术装置,用于解决髓管狭窄患者的挑战,这些患者不适合使用较大的伸缩棒。本研究旨在评估小儿成骨不全患者使用SLIM钉的结果和并发症。方法:对我院2016年4月至2022年3月间采用SLIM钉行手术的23例患者(41条肢体)进行回顾性图表分析。收集了患者人口统计学、手术干预、术后结果和并发症的数据。从术后立即到最近的随访期间进行放射学评估。结果:SLIM钉在胫骨上的2年生存率为82.8%,4年生存率为77.1%。最常见的并发症是胫骨远端角畸形,共发生19例。其他并发症包括前皮质穿透、指甲弯曲和1例指甲断裂。结论:对于髓内管狭窄的患者,SLIM钉子是一种可行的选择,特别是在伸缩棒不可行的情况下。虽然SLIM钉子提供了足够的稳定性,减少了多次手术的需要,但仔细监测对于控制并发症(如远端角畸形)是必不可少的。在可能的情况下,建议尽早翻修更大的支架,以防止随着患者的生长出现进一步的并发症。证据等级:四级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
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