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Article summary:
1. Intramedullary fixation is the standard form of surgical fixation of the long bones of children with osteogenesis imperfecta (OI).
2. This study describes a supplemental plate and screw construct at a fracture or an osteotomy site in addition to an intramedullary device in the long bone segment as a way to decrease risks of implant failure.
3. The study found that all 14 long bone segments treated with intramedullary fixation and a supplemental plate and screw construct went on to radiographic union, with an average time to union of 8.8 weeks.
Article analysis:
This article provides a detailed description of the surgical technique and early results of plate and screw fixation used to supplement intramedullary fixation in a subset of patients with OI. The authors provide evidence for their claims, such as citing previous studies on the complications associated with intramedullary long bone fixation in children with OI, as well as providing data from their own study showing that all 14 long bone segments treated with intramedullary fixation and a supplemental plate and screw construct went on to radiographic union, with an average time to union of 8.8 weeks.
The article does not appear to be biased or one-sided, as it presents both sides equally by discussing both the risks associated with intramedullary long bone fixation in children with OI, as well as presenting evidence for the efficacy of using supplemental plate and screw constructs at fracture or osteotomy sites. Furthermore, potential risks are noted throughout the article, such as implant breakage, implant cut out, long bone fracture, nonunion, and rod bending.
The only potential issue is that there is no discussion about possible counterarguments or alternative treatments that could be used instead of this particular technique. However, overall this article appears to be reliable and trustworthy due its thoroughness in discussing both sides equally and providing evidence for its claims.