Percutaneous epiphysiodesis using transphyseal screws (PETS).
We describe a new technique of percutaneous epiphysiodesis using transphyseal screws (PETS) and our experience with it in 32 cases of limb-length inequality and nine angular knee deformities. A subgroup of 18 patients with postfracture limb overgrowth formed a clinical model for study of the real efficacy of PETS. It proved a reliable method with few complications and many advantages such as simplicity of technique, short operating time, rapid postoperative rehabilitation, and reversibility. Bone-length inequality decreased from a preepiphysiodesis average of 2.47 cm (range, 1.5-4.6) to 0.51 cm at skeletal maturity. The tibiofemoral angle reduced from a preoperative average of 7.66 degrees to 0.86 degrees at maturity. The screws began to exert significant growth inhibition within 6 months of insertion, slowing down the distal femoral and upper tibial physes by 68 and 56%, respectively. They achieved maximum growth retardation over the ensuing 12 months, slowing down the distal femoral physis by 89% and the proximal tibial physis by 95%. At skeletal maturity, total femoral growth was 45% and total tibial growth was 52% that of the normal side. Key
Métaizeau
J P
JP
Service d'Orthopédie Pédiatrique, Hôpital Belle-Isle, Metz, France.
Wong-Chung
J
J
Bertrand
H
H
Pasquier
P
P
D001848:Bone Diseases, Developmental / Q000503:physiopathology / Q000601:surgery; D001863:Bone Screws; D004838:Epiphyses / Q000254:growth & development / Q000601:surgery*; D005269:Femur / Q000033:anatomy & histology / Q000254:growth & development / Q000601:surgery*; D006801:Humans; D007717:Knee / Q000002:abnormalities* / Q000601:surgery; D007870:Leg Length Inequality / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D013977:Tibia / Q000033:anatomy & histology / Q000254:growth & development / Q000601:surgery*