Peter Joseph Mounsef, Jack Legler, Dev Patel, Reggie Hamdy
{"title":"Evolution and outcomes of telescoping intramedullary rods in pediatric bone fragility disorders: A systematic review.","authors":"Peter Joseph Mounsef, Jack Legler, Dev Patel, Reggie Hamdy","doi":"10.1177/18632521261423059","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>Telescoping intramedullary rods have transformed the management of long bone deformity and fragility fractures in children, yet complications and revision surgery remain common. This systematic review synthesizes outcomes across telescoping systems to evaluate complication and revision rates, telescoping success, and design evolution to guide implant selection and surgical decision-making in pediatric orthopedics.</p><p><strong>Methods: </strong>A search was conducted through July 2025 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting outcomes of telescoping rods in pediatric patients were included. Due to heterogeneity, results were synthesized descriptively and presented as weighted means per operated bone.</p><p><strong>Results: </strong>Thirty-three studies (861 patients; 2054 rods) were included. Weighted mean complication and revision rates were 49.6% and 25.7% for Bailey-Dubow rods, 61.1% and 24.5% for Sheffield rods, 37.1% and 30.5% for Fassier-Duval rods, 14.9% and 9.0% for corkscrew-locking rods, and 46.7% and 6.7% for distal-female rods. Telescoping success was 48% for Bailey-Dubow, 74% for Fassier-Duval, 94% for corkscrew, and 100% for distal-female designs. Variation in follow-up duration and definitions of complications contributed to differences in reported rates.</p><p><strong>Conclusions: </strong>Modern telescoping rods have reduced migration and mechanical failure compared with earlier designs, yet complication and revision rates remain substantial. Newer systems show encouraging early results but require longer follow-up for validation. Differences in bone anatomy and biomechanics strongly influence implant performance, underscoring the need to tailor rod selection to individual bones.</p><p><strong>Significance: </strong>This review consolidates published complication and revision rates across telescoping rod designs, establishing a foundation for comparison as newer implants are introduced and long-term outcome data become available.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":" ","pages":"185-196"},"PeriodicalIF":1.8000,"publicationDate":"2026-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12913040/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Childrens Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/18632521261423059","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/4/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose: Telescoping intramedullary rods have transformed the management of long bone deformity and fragility fractures in children, yet complications and revision surgery remain common. This systematic review synthesizes outcomes across telescoping systems to evaluate complication and revision rates, telescoping success, and design evolution to guide implant selection and surgical decision-making in pediatric orthopedics.
Methods: A search was conducted through July 2025 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies reporting outcomes of telescoping rods in pediatric patients were included. Due to heterogeneity, results were synthesized descriptively and presented as weighted means per operated bone.
Results: Thirty-three studies (861 patients; 2054 rods) were included. Weighted mean complication and revision rates were 49.6% and 25.7% for Bailey-Dubow rods, 61.1% and 24.5% for Sheffield rods, 37.1% and 30.5% for Fassier-Duval rods, 14.9% and 9.0% for corkscrew-locking rods, and 46.7% and 6.7% for distal-female rods. Telescoping success was 48% for Bailey-Dubow, 74% for Fassier-Duval, 94% for corkscrew, and 100% for distal-female designs. Variation in follow-up duration and definitions of complications contributed to differences in reported rates.
Conclusions: Modern telescoping rods have reduced migration and mechanical failure compared with earlier designs, yet complication and revision rates remain substantial. Newer systems show encouraging early results but require longer follow-up for validation. Differences in bone anatomy and biomechanics strongly influence implant performance, underscoring the need to tailor rod selection to individual bones.
Significance: This review consolidates published complication and revision rates across telescoping rod designs, establishing a foundation for comparison as newer implants are introduced and long-term outcome data become available.
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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