Eight plate guided growth for angular deformity correction in skeletally immature patients.
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Published:
Nov 19, 2015
Keywords:
Angular deformities, physis, eight plate, children
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Abstract
IntroductionPhyseal suppression allows correction of deformities in skeletally immature patients. Recently, a new implant (8 plates) that presents some advantages with its predecessors has been proposed. The aim of this study is to evaluate the radiographic results and complications in a consecutive series of patients treated with this method.MethodsThe medical records of all skeletally immature patients treated operatively to correct angular deformities of the lower extremities with guided growth – eight plates between January 2009 and July 2013 were retrospectively reviewed. Demographics, radiographic angular deformity correction and complication rate were evaluated.Results27 patients (47 physes) were evaluated. 38 were treated by valgus deformity varus and 9. Of 47 physis, 33 were in the distal femur, proximal tibia 12 and2 in the distal tibia. Age at the time of surgery averaged 11.8 ± 1.36 years (range 8 - 14). The average time between implant placement and removal was 10.6 ± 3 months (range 7-26 months). All patients except one completed correction of the deformity. There were 6 postoperative complications, and 2 required reintervention (1 rebound and 1 implant migration).ConclusionsThe use of plates in 8 for correction of angular deformities in skeletally immature patients is an effective method with a low complication rate.
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Tourn, D., Allende, V., & Masquijo, J. J. (2015). Eight plate guided growth for angular deformity correction in skeletally immature patients. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 80(4), 254-259. https://doi.org/10.15417/448
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Clinical Research
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References
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12. Stevens PM. Guided growth for angular correction: a preliminary series using a tension band plate. J Pediatr Orthop 2007;27:253-9.
13. Masquijo JJ, Lanfranchi L, Torres-Gomez A, Allende V. Guided growth with the tension band plate construct: a prospective comparison of 2 methods of implant placement. J Pediatr Orthop 2015;35(3):e20-5.
14. Paley D, Tetsworth K. Mechanical axis deviation of the lower limbs. Preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop Relat Res 1992;(280):48-64.
15. Stevens PM, Maguire M, Dales MD, Robins AJ. Physeal stapling for idiopathic genu valgum. J Pediatr Orthop 1999;19(5):645-9.
16. Burghardt RD, Specht SC, Herzenberg JE, MD Mechanical failures of eight-plate guided growth system for temporary hemiepiphysiodesis. J Pediatr Orthop 2010;30:594-7.
17. Oda JE, Thacker MM. Distal tibial physeal bridge: a complication from a tension band plate and screw construct. Report of a case. J Pediatr Orthop Br 2013;22(3):259-63.
18. Ballal MS, Bruce CE, Nayagam S. Correcting genu varum and genu valgum in children by guided growth. J Bone Joint Surg Br 2010;92:273-6.
19. Cozen L. Fracture of the proximal portion of the tibia in children followed by valgus deformity. Surg Gynecol Obstet 1953;97(2):183-8.
20. Jackson DW, Cozen L. Genu valgum as a complication of proximal tibial metaphyseal fractures in children. J Bone Joint Surg Am 1971;53(8):1571-8.
21. 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.
22. Stevens PM, Pease F, Hemiepiphysiodesis for posttraumatic tibial valgus, J Pediatr Orthop 2006;26:385-92.
23. Burghardt RD, Herzenberg JE. Temporary hemiepiphysiodesis with the eight-plate for angular deformities: mid-term results. J Orthop Sci 2010;15:699-704.
24. Goyeneche RA, Primomo CE, Lambert N, Miscione H. Correction of bone angular deformities: experimental analysis of staples versus 8-plate. J Pediatr Orthop 2009;29(7):736-40.
25. Gordon JE, Chen RC, Dobbs MB, Luhmann SJ, Rich MM, Schoenecker PL. Interobserver and intraobserver reliability in the evaluation of mechanical axis deviation. J Pediatr Orthop 2009;29(3):281-4.
2. Volkmann R. Diseases of the musculoskeletal system. En: von Pitha FR, Billroth T, eds. Handbuch der allgemeinen und speziellen Chirurgie. Zweiter Band, zweite Abteilung, erste Halfte. Stuttgart, Germany: Ferdinand Enke; 1865:234-920.
3. Pinkowski JL, Weiner DS. Complications in proximal tibial osteotomies in children with presentation of technique. J Pediatr Orthop 1995;15:307-12.
4. Steel HH, Sandrow RE, Sullivan PD. Complications of tibial osteotomy in children for genu varum or valgum. Evidence that neurological changes are due to ischemia. J Bone Joint Surg Am 1971;53:1629-35.
5. Phemister DB. Operative arrestment of longitudinal growth of bones in the treatment of deformities. J Bone Joint Surg Am 1933;15:1-15.
6. Blount WP, Clarke GR. Control of bone growth by epiphyseal stapling: a preliminary report. J Bone Joint Surg Am 1949;31:464-78.
7. May VR Jr, Clements EL. Epiphyseal stapling: with special reference to complications. South Med J 1965;58:1203-7.
8. Zuege RC, Kempken TG, Blount WP. Epiphyseal stapling for angular deformity at the knee. J Bone Joint Surg Am 1979;61:320-9.
9. Frantz CH. Epiphyseal stapling: a comprehensive review. Clin Orthop 1971;77:149-57.
10. Métaizeau JP, Wong-Chung J, Bertrand H, Pasquier P. Percutaneous epiphysiodesis using transphyseal screws (PETS). J Pediatr Orthop 1998;18(3):363-9.
11. Shin SJ, Cho TJ, Park MS, Bae JY, Yoo WJ, Chung ChY, et al. Angular deformity correction by asymmetrical physeal suppression in growing children: stapling versus percutaneous transphyseal screw. J Pediatr Orthop 2010;30(6):588-93.
12. Stevens PM. Guided growth for angular correction: a preliminary series using a tension band plate. J Pediatr Orthop 2007;27:253-9.
13. Masquijo JJ, Lanfranchi L, Torres-Gomez A, Allende V. Guided growth with the tension band plate construct: a prospective comparison of 2 methods of implant placement. J Pediatr Orthop 2015;35(3):e20-5.
14. Paley D, Tetsworth K. Mechanical axis deviation of the lower limbs. Preoperative planning of uniapical angular deformities of the tibia or femur. Clin Orthop Relat Res 1992;(280):48-64.
15. Stevens PM, Maguire M, Dales MD, Robins AJ. Physeal stapling for idiopathic genu valgum. J Pediatr Orthop 1999;19(5):645-9.
16. Burghardt RD, Specht SC, Herzenberg JE, MD Mechanical failures of eight-plate guided growth system for temporary hemiepiphysiodesis. J Pediatr Orthop 2010;30:594-7.
17. Oda JE, Thacker MM. Distal tibial physeal bridge: a complication from a tension band plate and screw construct. Report of a case. J Pediatr Orthop Br 2013;22(3):259-63.
18. Ballal MS, Bruce CE, Nayagam S. Correcting genu varum and genu valgum in children by guided growth. J Bone Joint Surg Br 2010;92:273-6.
19. Cozen L. Fracture of the proximal portion of the tibia in children followed by valgus deformity. Surg Gynecol Obstet 1953;97(2):183-8.
20. Jackson DW, Cozen L. Genu valgum as a complication of proximal tibial metaphyseal fractures in children. J Bone Joint Surg Am 1971;53(8):1571-8.
21. 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.
22. Stevens PM, Pease F, Hemiepiphysiodesis for posttraumatic tibial valgus, J Pediatr Orthop 2006;26:385-92.
23. Burghardt RD, Herzenberg JE. Temporary hemiepiphysiodesis with the eight-plate for angular deformities: mid-term results. J Orthop Sci 2010;15:699-704.
24. Goyeneche RA, Primomo CE, Lambert N, Miscione H. Correction of bone angular deformities: experimental analysis of staples versus 8-plate. J Pediatr Orthop 2009;29(7):736-40.
25. Gordon JE, Chen RC, Dobbs MB, Luhmann SJ, Rich MM, Schoenecker PL. Interobserver and intraobserver reliability in the evaluation of mechanical axis deviation. J Pediatr Orthop 2009;29(3):281-4.