The efficacy of hemiepiphysiodesis for idiopathic knee coronal angular deformity by reconstruction plate and screw: A pilot study.

Autor: Maleki A; Department of Orthopedic Surgery Akhtar Hospital, Shahid Beheshti University of Medical Sciences Tehran Iran., Qoreishi M; Department of Orthopedic Surgery Akhtar Hospital, Shahid Beheshti University of Medical Sciences Tehran Iran., Bisadi A; Department of Orthopedic Surgery Akhtar Hospital, Shahid Beheshti University of Medical Sciences Tehran Iran., Safdari F; Department of Orthopedic Surgery Akhtar Hospital, Shahid Beheshti University of Medical Sciences Tehran Iran., Daei Sorkhabi A; Student Research Committee Tabriz University of Medical Sciences Tabriz Iran., Fotouhi A; Department of Orthopedic Surgery, Faculty of Medicine Tabriz University of Medical Sciences Tabriz Iran., Tahririan MA; Department of Orthopedic Surgery, Faculty of Medicine Isfahan University of Medical Sciences Isfahan Iran.
Jazyk: angličtina
Zdroj: Health science reports [Health Sci Rep] 2023 Jun 11; Vol. 6 (6), pp. e1302. Date of Electronic Publication: 2023 Jun 11 (Print Publication: 2023).
DOI: 10.1002/hsr2.1302
Abstrakt: Background: Angular deformities of the lower extremities are among the most common findings in pediatric orthopedics. Alteration of the mechanical axis in the lower extremity affects the cosmetic appearance and may lead to gait disturbances, knee discomfort, patellar maltracking with or without pain, and early joint osteoarthritis. In the current study, we aimed to investigate the efficacy of 3-hole 3.5 mm reconstruction plates in tension-band temporary hemiepiphysiodesis for correcting idiopathic knee coronal angular deformities.
Methods: The surgical procedure was performed using an extraperiosteal tension band plate (a 3-hole reconstruction plate) and two 3.5 mm cortical screws to treat idiopathic knee coronal angular deformity in children. The location of the hemiepiphysiodesis was determined based on the type of angular deformity present. Postoperative follow-ups were conducted through x-rays to measure the medial proximal tibial angle and lateral distal femoral angle of the limbs. Statistical analysis was then performed to evaluate the efficacy of the surgical treatment based on the rate of alignment change exhibited.
Results: The study included 14 patients (25 limbs) with genu valgum deformity who underwent temporary hemiepiphysiodesis on both the distal femur and proximal tibia, with 16 proximal tibias and 15 distal femurs being corrected. The correction rate for genu valgum was found to be 0.59° per month for both proximal tibial and distal femoral hemiepiphysiodesis. Six patients (12 limbs) were also identified with genu varum deformity, and the correction rates for proximal tibial lateral hemiepiphysiodesis and distal femoral lateral hemiepiphysiodesis were 0.85° and 0.15° per month, respectively. During a mean follow-up duration of 11 ± 5.7 months, only one case of physeal plate closure was observed, and there were no other significant complications.
Conclusion: Temporary hemiepiphysiodesis with a 3-hole R-plate and two cortical screws takes advantage of physiological physeal growth to successfully treat idiopathic angular deformities with low complication rates.
Competing Interests: The authors declare no conflict of interest.
(© 2023 The Authors. Health Science Reports published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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