Is Proximal Fibula Epiphysiodesis Necessary When Performing a Proximal Tibial Epiphysiodesis?
| Autor: | David A. Podeszwa, Jonathan Boyle, Chan Hee Jo, Jennifer A. Rodgers, John G. Birch, Marina R. Makarov |
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| Rok vydání: | 2020 |
| Předmět: |
musculoskeletal diseases
Male medicine.medical_specialty Adolescent medicine.medical_treatment Radiography Fibular overgrowth 03 medical and health sciences 0302 clinical medicine Proximal fibula medicine Humans Orthopedics and Sports Medicine Tibia Fibula Child Retrospective Studies 030222 orthopedics Bone Development business.industry Epiphysiodesis Retrospective cohort study General Medicine musculoskeletal system Surgery Leg Length Inequality surgical procedures operative Concomitant Pediatrics Perinatology and Child Health Female business |
| Zdroj: | Journal of pediatric orthopedics. 40(10) |
| ISSN: | 1539-2570 |
| Popis: | BACKGROUND Controversy exists regarding the need for proximal fibular epiphysiodesis in conjunction with proximal tibial epiphysiodesis to prevent relative overgrowth of the fibula. The purpose of this study was to determine the incidence of relative fibular overgrowth in patients who had undergone proximal tibial epiphysiodesis with or without proximal fibular epiphysiodesis to manage leg-length discrepancy. METHODS We identified patients who had undergone proximal tibial epiphysiodesis, with or without concomitant fibular epiphysiodesis, followed to skeletal maturity, and with adequate scanograms to measure tibial and fibular lengths. We assessed tibial and fibular lengths, ratios, and distances between the tibia and fibula proximally and distally preoperatively and at skeletal maturity, and obvious radiographic proximal migration of the fibular head. RESULTS A total of 234 patients met inclusion criteria, including 112 girls and 122 boys. In total, 179 patients had undergone concomitant fibular epiphysiodesis, and 55 had not. The fibular epiphysiodesis group was significantly younger preoperatively than the nonfibular epiphysiodesis group (average: 12.3 vs. 13.6 y), which accounted for most of the preoperative differences noted between the groups. Within the subset of younger patients (≥2 y of growth remaining at the time of epiphysiodesis), there were statistically significant differences between those with or without fibular epiphysiodesis at skeletal maturity in the proximal tibial-fibular distance (P |
| Databáze: | OpenAIRE |
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