Perbandingan Efikasi dan Komplikasi Teleskopik Versus Non-Teleskopik Intramedulari Rod Pada Pasien Pediatrik Dengan Osteogenesis Imperfekta Meta-Analisis

Abstract

BACKGROUND Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by bone fragility due to collagen type I synthesis defects. Surgical management of long bone deformities and recurrent fractures in pediatric patients often involves intramedullary rodding. Telescopic rods are designed to accommodate growth, while non-telescopic rods remain in use. However, their comparative efficacy and safety remain debated METHODS This study is a systematic review and meta-analysis comparing telescopic and non-telescopic rods in pediatric OI. Literature searches were conducted in PubMed, Scopus, and Europe PMC using PICO criteria. Data were analyzed with RevMan 5.4 to calculate pooled risk ratios (RR) and 95% confidence intervals (CI), with heterogeneity assessed using I² statistics and bias evaluated by ROBINS-I. RESULTS Eleven studies with a total of 1,032 patients were included. Telescopic rods showed significantly lower refracture rates (RR 0.39; 95% CI: 0.23–0.64; p<0.001) and fewer non-unions (RR 0.35; 95% CI: 0.12–1.00; p=0.05). Revision surgeries and implant failures were also less frequent in the telescopic group. Implant survival rates were superior compared with non-telescopic rods. CONCLUSION Telescopic rods provide superior outcomes in reducing refractures, complications, and revision surgeries compared with non-telescopic rods in pediatric OI patients. Despite greater technical demands, telescopic rods should be considered the preferred choice for long bone deformity management in OI.