Temporary epiphyseodesis for limb-length discrepancy. 8- to 15-year follow-up of 34 children
| Autor: | Sandra Breyer, Karsten Ridderbusch, Ralf Stücker, Markus Siedhoff, Martin Rupprecht |
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| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Radiography Arthrodesis Implant removal Device removal Bone Lengthening medicine Humans Orthopedics and Sports Medicine In patient Femur Limb length discrepancy Child Mechanical axis Children Device Removal Sutures Tibia business.industry Mean age General Medicine Skeletal maturity Surgery Leg Length Inequality Prosthesis Failure Treatment Outcome Female business Epiphyses Follow-Up Studies |
| Zdroj: | Acta Orthopaedica |
| ISSN: | 1745-3682 |
| Popis: | Background and purpose — For the treatment of leg-length discrepancies (LLDs) of between 2 and 5 cm in adolescent patients, several epiphyseodesis options exist and various complications have been reported. We reviewed the 8- to 15-year outcome after temporary epiphyseodesis in patients with LLD. Patients and methods — 34 children with LLD of up to 5 cm were included in the study. Mean age at epiphyseodesis was 12.8 (10–16) years. Temporary epiphyseodesis was performed with Blount staples or 8-plates. The LLD was reviewed preoperatively, at the time of implant removal, and at follow-up. Every child had reached skeletal maturity at follow-up. Long-standing anteroposterior radiographs were analyzed with respect to the mechanical axis and remaining LLD at the time of follow-up. Possible complications were noted. Results — The mean LLD changed from 2.3 (0.9–4.5) cm to 0.8 (–1.0 to 2.6) cm at follow-up (p < 0.001). 21 patients had a final LLD of < 1 cm, and 10 had LLD of < 0.5 cm. At the time of follow-up, in 32 patients the mechanical axis crossed within Steven’s zone 1. No deep infections or neurovascular lesions were seen. 4 implant failures occurred, which were managed by revision. Interpretation — Temporary epiphyseodesis is an effective and safe option for the treatment of LLD. The timing of the procedure has to be chosen according to the remaining growth, facilitating a full correction of the LLD. If inaccurate placement of staples is avoided, substantial differences between the mechanical axes of both legs at skeletal maturity are rare. |
| Databáze: | OpenAIRE |
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