Poor Efficiency of Eight-Plates in the Treatment of Lower Limb Discrepancy
| Autor: | E. Gaumetou, Cindy Mallet, Brice Ilharreborde, Keyvan Mazda, Philippe Souchet |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Adolescent medicine.medical_treatment Lower limb Stereoradiography 03 medical and health sciences Postoperative Complications 0302 clinical medicine Bone Lengthening Bone plate medicine Humans Orthopedics and Sports Medicine Femur Growth Plate 030212 general & internal medicine Child 030222 orthopedics Tibia business.industry Epiphysiodesis Level iv General Medicine Perioperative Skeletal maturity Standard technique Leg Length Inequality Surgery Radiography Treatment Outcome Pediatrics Perinatology and Child Health Female business Bone Plates |
| Zdroj: | Journal of Pediatric Orthopaedics. 36:715-719 |
| ISSN: | 0271-6798 |
| DOI: | 10.1097/bpo.0000000000000518 |
| Popis: | Background Among the numerous existing epiphysiodesis procedures, the eight-plate-guided growth technique, initially described for angular deformities correction, has progressively gained popularity among pediatric orthopaedic surgeons to treat lower limb discrepancy (LLD). The goal of this study was to assess the efficacy of eight-plates in LLD. Methods All children treated for LLD with eight-plates were prospectively included and followed until skeletal maturity. Efficacy of the epiphysiodesis was calculated 6 and 18 months postoperatively and at latest follow-up, according to a method previously validated for percutaneous epiphysiodesis using transphyseal screws (PETS). Radiologic measurements were performed using 3-dimensional low-dose stereoradiography. Intraoperative and postoperative complications were reported. Results Thirty-two patients were included (average age at surgery, 12.5 y). For femoral epiphysiodesis, efficacy was only 23% at 6 months and 68% at latest follow-up. The procedure was even less efficient on the proximal tibia, with only 42% of the expected growth arrest at latest examination. Eight patients (20%) experienced plate-related pain during follow-up, and 5 physes (12.5%) required unplanned revision surgery. Conclusions Results of the current series show that the eight-plate technique procedure was associated with few perioperative complications, but the growth arrest observed at follow-up was unpredictable and lower than that achieved with PETS in previous reports. Eight-plate procedures cannot be considered as an efficient epiphysiodesis technique in comparison with standard technique. Level of evidence Level IV. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|