title: Temporary epiphyseodesis for limb-length discrepancy. 8- to 15-year follow-up of 34 children.
abstract: OBJECTIVE
  For the treatment of leg-length discrepancies (LLDs) of between 2 and 5 cm in adolescent patients, several epiphyseodesis options exist and various complications have been reported. We reviewed the 8- to 15-year outcome after temporary epiphyseodesis in patients with LLD.
  
  
  METHODS
  34 children with LLD of up to 5 cm were included in the study. Mean age at epiphyseodesis was 12.8 (10-16) years. Temporary epiphyseodesis was performed with Blount staples or 8-plates. The LLD was reviewed preoperatively, at the time of implant removal, and at follow-up. Every child had reached skeletal maturity at follow-up. Long-standing anteroposterior radiographs were analyzed with respect to the mechanical axis and remaining LLD at the time of follow-up. Possible complications were noted.
  
  
  RESULTS
  The mean LLD changed from 2.3 (0.9-4.5) cm to 0.8 (-1.0 to 2.6) cm at follow-up (p<0.001). 21 patients had a final LLD of <1 cm, and 10 had LLD of <0.5 cm. At the time of follow-up, in 32 patients the mechanical axis crossed within Steven's zone 1. No deep infections or neurovascular lesions were seen. 4 implant failures occurred, which were managed by revision.
  
  
  CONCLUSIONS
  Temporary epiphyseodesis is an effective and safe option for the treatment of LLD. The timing of the procedure has to be chosen according to the remaining growth, facilitating a full correction of the LLD. If inaccurate placement of staples is avoided, substantial differences between the mechanical axes of both legs at skeletal maturity are rare.
authors.affiliation: Department of Pediatric Orthopaedics , Altonaer Children's Hospital, Hamburg and Department of Orthopaedics, University Medical Center Hamburg-Eppendorf , Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Siedhoff
authors.forename: Karsten
authors.initials: K
authors.lastname: Ridderbusch
authors.forename: Sandra
authors.initials: S
authors.lastname: Breyer
authors.forename: Ralf
authors.initials: R
authors.lastname: Stücker
authors.forename: Martin
authors.initials: M
authors.lastname: Rupprecht
mesh_terms: D000293:Adolescent; D001174:Arthrodesis / Q000009:adverse effects / Q000379:methods*; D001852:Bone Lengthening / Q000379:methods*; D002648:Child; D020878:Device Removal; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005269:Femur / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007870:Leg Length Inequality / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D011475:Prosthesis Failure; D011859:Radiography; D013537:Sutures; D013977:Tibia / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome