Growth Modulation in Renal Osteodystrophy

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Published: Dec 1, 2012
DOI: https://doi.org/10.15417/126
Keywords:
Guided growth, Growth modulation, Hemiepiphysiodesis, Pathological physes, Renal osteodystrophy

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Fernando Miscione
Rodolfo Goyeneche
Claudio Primomo
Horacio Miscione

Abstract

BackgroundRenal osteodystrophy causes progressive mechanical axis deviation, most often genu valgum, of the lower limbs. Guided growth is a useful procedure for the correction of angular deformities in children. Temporary partial closure of the physis (hemiepiphysiodesis) is a good therapeutic option. The aim of this study was to show the outcome and complications of this surgical procedure in pathological physes.MethodsWe present 11 patients (20 knees) diagnosed with chronic renal insufficiency and genu valgum who underwent temporary hemiepiphysiodesis at our Department. Eight-plates were placed in four patients and stapling was performed in the remaining seven. Pre and post-operative mechanical axis was evaluated on radiographs and the complications associated with each implant were assessed.ResultsComplete correction was obtained in four patients, one of whom suffered from recurrence of the deformity, and the remaining patients improved without achieving full normalization of the mechanical axis.ConclusionsThe correction achieved was clearly related to restore of kidney function. Patients who underwent kidney transplantation achieved adequate catch-up bone growth. No differences were found in outcome or complications between the two implants used. 

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How to Cite
Miscione, F., Goyeneche, R., Primomo, C., & Miscione, H. (2012). Growth Modulation in Renal Osteodystrophy. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 77(3), 171-177. https://doi.org/10.15417/126
Issue
Vol 77 No 3 (2012)
Section
Clinical Research
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References

1. Sprague SM. Renal bone disease. Curr Opin Endocrinol Diabetes Obes 2010;17(6):535-9.

2. González C, Delucchi ÁB. Guías Prácticas de Osteodistrofia Renal en Pediatría. Recomendación de la Rama de Nefrología Sociedad Chilena de Pediatría. Rev Chil Pediatr 2006;77(1):84-91.

3. Barrett IR, Papadimitriou DG. Skeletal disorders in children with renal failure. J Pediatr Orthop 1996;16(2):264-72.

4. Oppenheim WL, Fischer SR, Salusky IB. Surgical correction of angular deformity of the knee in children with renal osteodystrophy. J Pediatr Orthop 1997;17:41-9.
5. Castañeda P, Urquhart B, Sullivan E, Haynes RJ. Hemiepiphysiodesis for the correction of angular deformity about the knee. J Pediatr Orthop 2008;28(2):188-91.

6. Phemister DB. Operative assessment of longitudinal growth of long bones in the treatment of deformities. J Bone Joint Surg
1933;15:1-15.
7. Blount WP, Clarke GR. Control of bone growth by epiphyseal stapling. Preliminary report. J Bone Joint Surg Am 1949;31: 464-78.

8. Métaizeau JP, Wong-Chung J, Bertrand H, Pasquier P. Percutaneous epiphysiodesis using transphyseal screws (PETS). J Pediatr Orthop 1998;18(3):363-9.

9. Langenskiöld A. Role of the ossification groove of Ranvier in normal and pathologic bone growth: a review. J Pediatr Orthop 1998;18(2):173-7.

10. Mielke CH, Stevens PM. Hemiepiphyseal stapling for knee deformities in children younger than 10 years: a preliminary report. J Pediatr Orthop 1996;16(4):423-9.

11. Haffner D, Fischer DC. Bone cell biology and pediatric renal osteodystrophy. Minerva Pediatr 2010;62(3):273-84.

12. Saran N, Rathjen KE. Guided growth for the correction of pediatric lower limb angular deformity. J Am Acad Orthop Surg 2010;18(9):528-36.
13. Muller K, Muller-Farber J. Indications, localization and planning osteotomies about the knee. In: Hierholzer G, Muller K, eds. Corrective osteotomies of the lower extremity after trauma. Berlin: Springer-Verlag, 1984, p. 195-223.

14. Stevens P, Klatt JB. Guided growth for pathological physes: radiographic improvement during realignment. J Pediatr Orthop 2008;28(6):632-9.

15. Stevens P, Novais E. Hypophosphatemic rickets: the role of hemiepiphysiodesis. J Pediatr Orthop 2006;26(2):238-44.