Correcting genu varum and genu valgum in children by guided growth: temporary hemiepiphysiodesis using tension band plates.
A total of 25 children (37 legs and 51 segments) with coronal plane deformities around the knee were treated with the extraperiosteal application of a flexible two-hole plate and screws. The mean age was 11.6 years (5.5 to 14.9), the median angle of deformity treated was 8.3 degrees and mean time for correction was 16.1 months (7 to 37.3). There was a mean rate of correction of 0.7 degrees per month in the femur (0.3 degrees to 1.5 degrees ), 0.5 degrees per month in the tibia (0.1 degrees to 0.9 degrees ) and 1.2 degrees per month (0.1 degrees to 2.2 degrees ) if femur and tibia were treated concurrently. Correction was faster if the child was under 10 years of age (p = 0.05). The patients were reviewed between six and 32 months after plate removal. One child had a rebound deformity but no permanent physeal tethers were encountered. The guided growth technique, as performed using a flexible titanium plate, is simple and safe for treating periarticular deformities of the leg.
The Royal Liverpool Children's NHS Trust, Liverpool L12 2AP, UK. dr_moez@yahoo.co.uk
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Ballal
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Bruce
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Nayagam
D000293:Adolescent; D000367:Age Factors; D001860:Bone Plates; D002648:Child; D002675:Child, Preschool; D004838:Epiphyses / Q000254:growth & development / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D056304:Genu Valgum / Q000601:surgery*; D056305:Genu Varum / Q000601:surgery*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D013314:Stress, Mechanical; D014025:Titanium
D014025:Titanium