Tension-band Plating for Leg-length Discrepancy Correction.

Autor:	Tolk JJ; Department of Orthopaedics and Sports Medicine, Erasmus MC-Sophia Children's Hospital, Rotterdam, South Holland, Netherlands; Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom., Merchant R; Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom; Department of Trauma and Orthopaedics, Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom., Calder PR; Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom., Hashemi-Nejad A; Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom., Eastwood DM; Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom; Department of Orthopaedics, Great Ormond Street Hospital for Children, London, United Kingdom.
Jazyk:	angličtina
Zdroj:	Strategies in trauma and limb reconstruction [Strategies Trauma Limb Reconstr] 2022 Jan-Apr; Vol. 17 (1), pp. 19-25.
DOI:	10.5005/jp-journals-10080-1547
Abstrakt:	Aim: Dual tension-band plates are used for temporary epiphysiodesis and longitudinal guided growth. The study aim was to assess rate of correction, to identify development of femoral and tibial intra-articular deformity during correction and to document resumption of growth after plate removal. Materials and Methods: A retrospective study of 34 consecutive patients treated with dual tension-band plates between 2012 and 2020 was performed. Twenty-four patients had surgery at the distal femur, six at the proximal tibia and four at both. Twenty-five female patients were treated at a mean age of 11.6 (±1.4) years and nine male patients at 13.5 (±1.5) years. Measurements were performed on standardised long-leg radiographs and included leg-length discrepancy (LLD), joint line congruency angle (JLCA), tibial roof angle, femoral floor angle and notch-intercondylar distance. Measurements were taken pre-operatively, at the end of discrepancy correction and at skeletal maturity. Results: The LLD reduced by a mean of 12.9 mm (95% CI 10.2-15.5) with the mean residual difference 8.4 mm (95% CI 5.4-11.4). The mean correction rate for the proximal tibia was 0.40 (SD 0.33) mm/month and 0.68 (SD 0.36) mm/month for the distal femur. A significant mean change in residual LLD [-2.5 mm (95% CI -4.2 to -0.7)] was observed between plate removal and skeletal maturity at the femoral level only. After length discrepancy correction, the tibial roof angle showed a significant difference of 8.4° (95% CI 13.4-3.4) between legs. In femoral epiphysiodesis patients, no important differences were observed. Conclusion: A significant reduction in LLD can be achieved using dual tension-band plating. A change in intra-articular morphology was observed only in the proximal tibia and not in the distal femur. In the authors' opinion, tension-band plating is a useful tool for leg-length equalisation but should be reserved for younger patients or when residual growth is difficult to predict. It is one of the management strategies for limb-length difference prior to skeletal maturity. How to Cite This Article: Tolk JJ, Merchant R, Calder PR, et al . Tension-band Plating for Leg-length Discrepancy Correction. Strategies Trauma Limb Reconstr 2022;17(1):19-25. Competing Interests: Source of support: Nil Conflict of interest: None (Copyright © 2022; The Author(s).)
Databáze:	MEDLINE
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