{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:44:08Z","timestamp":1760060648590,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T00:00:00Z","timestamp":1757203200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Children"],"abstract":"<jats:p>Introduction: Osteogenesis imperfecta (OI) presents significant surgical challenges due to bone fragility, narrow medullary canals, and complex deformities. While telescoping rods like the Fassier\u2013Duval (FD) system are commonly used in growing patients, they are unsuitable when the canal diameter is too small or when patients approach skeletal maturity. The Simple Locking Intramedullary (SLIM) nail offers a solid, non-telescoping alternative in these cases. Methods: We describe the surgical technique for SLIM nail implantation and highlight key technical pearls developed through institutional experience, focusing on preoperative planning, intraoperative strategies, and the management of unique anatomical challenges in OI patients. Results: Three cases illustrate the application of these techniques: the first case demonstrates SLIM nail insertion in a 3-year-old child with a narrow IM canal to correct significant bowing; reaming was performed retrograde from the osteotomy site for the proximal segment and antegrade for the distal segment. The second case is a 15-year-old OI patient with a disengaged FD rod and narrow IM canal showing insertion of SLIM rod, and the third case is a 16-year-old patient with femoral deformity and telescoping rod who needed revision with SLIM nail and supplemental plate fixation. Conclusions: The SLIM nail is a viable option for select OI patients.<\/jats:p>","DOI":"10.3390\/children12091190","type":"journal-article","created":{"date-parts":[[2025,9,8]],"date-time":"2025-09-08T08:06:32Z","timestamp":1757318792000},"page":"1190","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tips and Tricks for Installation of the SLIM Nail in Osteogenesis Imperfecta with Narrow Medullary Canals: A Surgical Guide with Case Insights"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-0155-6329","authenticated-orcid":false,"given":"Peter Joseph","family":"Mounsef","sequence":"first","affiliation":[{"name":"Shriners Hospitals for Children, Montreal, QC H4A 0A9, Canada"},{"name":"Faculty of Medicine & Health Sciences, McGill University, Montreal, QC H3A 0G4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4308-7586","authenticated-orcid":false,"given":"Jack","family":"Legler","sequence":"additional","affiliation":[{"name":"Shriners Hospitals for Children, Montreal, QC H4A 0A9, Canada"},{"name":"Faculty of Medicine & Health Sciences, McGill University, Montreal, QC H3A 0G4, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Reggie","family":"Hamdy","sequence":"additional","affiliation":[{"name":"Shriners Hospitals for Children, Montreal, QC H4A 0A9, Canada"},{"name":"Faculty of Medicine & Health Sciences, McGill University, Montreal, QC H3A 0G4, Canada"},{"name":"Division of Pediatric Orthopaedic Surgery, Montreal Children\u2019s Hospital, Montreal, QC H4A 3H9, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1377","DOI":"10.1016\/S0140-6736(04)16051-0","article-title":"Osteogenesis imperfecta","volume":"363","author":"Rauch","year":"2004","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1136\/jmg.16.2.101","article-title":"Genetic heterogeneity in osteogenesis imperfecta","volume":"16","author":"Sillence","year":"1979","journal-title":"J. Med. Genet."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1097\/MOP.0000000000000968","article-title":"Osteogenesis imperfecta: Treatment and surgical management","volume":"33","author":"Green","year":"2021","journal-title":"Curr. Opin. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1007\/s11914-021-00665-z","article-title":"Osteogenesis Imperfecta\u2014Who Needs Rodding Surgery?","volume":"19","author":"Fassier","year":"2021","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e266775","DOI":"10.1590\/1413-785220233103e266775","article-title":"Treatment of Osteogenesis Imperfecta Using the Fassier-Duval Telescopic Rod","volume":"31","author":"Goiano","year":"2023","journal-title":"Acta Ortop. Bras."},{"key":"ref_6","unstructured":"(2024, June 29). SLIM\u2122\u2014Simple Locking IntraMedullary System. 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Orthop."},{"key":"ref_11","first-page":"200","article-title":"Telescoping versus non-telescoping rods in the treatment of osteogenesis imperfecta","volume":"75","author":"Khalil","year":"2009","journal-title":"Acta Orthop. Belg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e301","DOI":"10.1097\/BPO.0000000000002040","article-title":"Complications of Elongating Intramedullary Rods in the Treatment of Lower Extremity Fractures for Osteogenesis Imperfecta: A Meta-Analysis of 594 Patients in 40 Years","volume":"42","author":"Yong","year":"2022","journal-title":"J. Pediatr. Orthop."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1097\/BPO.0000000000002810","article-title":"Long-term Outcomes of Intramedullary Nails in Osteogenesis Imperfecta: Fewer Surgeries and Longer Survival Times With Telescoping Rods in Patients With Over Ten Years Follow-up","volume":"45","author":"Nguyen","year":"2025","journal-title":"J. Pediatr. 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Orthop."}],"container-title":["Children"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/9\/1190\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:41:31Z","timestamp":1760035291000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2227-9067\/12\/9\/1190"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,7]]},"references-count":15,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["children12091190"],"URL":"https:\/\/doi.org\/10.3390\/children12091190","relation":{},"ISSN":["2227-9067"],"issn-type":[{"type":"electronic","value":"2227-9067"}],"subject":[],"published":{"date-parts":[[2025,9,7]]}}}