title: Growth guidance of angular lower limb deformities using a one-third two-hole tubular plate.
abstract: OBJECTIVE
  The eight-plate system for angular deformity correction is well known, reliable and effective at any age during growth. Due to high implant costs, we sought to evaluate the effectiveness and safety of a less expensive alternative.
  
  
  METHODS
  Between 2006 and 2011, 41 children with angular deformities were managed using a two-hole one-third tubular plate in cases where an eight plate would normally be indicated. Inclusion criteria in this retrospective study were: genu valgum and genu varum. X-ray documentation was performed before and after surgery and patients were followed clinically every 3 months after surgery. The cost per implant was 361.40 Sfr (Swiss Francs) compared to the eight plate at 737 Sfr.
  
  
  RESULTS
  Mean time for correction was 13 months. A mean LDFA/MPTA after correction of 89.9°/86.8° was recorded, as well as a mean correction angle of 6.8°/6.6°. The complication rate was 6.6 % (one superficial wound infection and one insufficient correction in an older child). These results compare favourably with published data on the eight plate.
  
  
  CONCLUSIONS
  The two hole one-third tubular plate seems to be a clinically and also cost effective alternative to the eight plate. Full deformity correction is gained for a fraction of the cost.
  
  
  METHODS
  Level III.
authors.affiliation: Karolinska University Stockholm, 17176 Stockholm, Sweden.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Böhm
authors.affiliation: Karolinska University Stockholm, 17176 Stockholm, Sweden.
authors.forename: Andreas H
authors.initials: AH
authors.lastname: Krieg
authors.affiliation: Karolinska University Stockholm, 17176 Stockholm, Sweden.
authors.forename: Fritz
authors.initials: F
authors.lastname: Hefti
authors.affiliation: Karolinska University Stockholm, 17176 Stockholm, Sweden.
authors.forename: Reinald
authors.initials: R
authors.lastname: Brunner
authors.affiliation: Karolinska University Stockholm, 17176 Stockholm, Sweden.
authors.forename: Carol C
authors.initials: CC
authors.lastname: Hasler
authors.affiliation: Karolinska University Stockholm, 17176 Stockholm, Sweden.
authors.forename: Mark
authors.initials: M
authors.lastname: Gaston
keywords: Angular deformities; Deformity correction; Growth guidance; Lower limb