title: Comparative study between staples and eight plate in the management of coronal plane deformities of the knee in skeletally immature children.
abstract: OBJECTIVE
  To compare two commonly used methods of temporary hemiepiphysiodesis (staples and figure of eight plate) in the management of coronal plane deformities of the knee in skeletally immature children.
  
  
  METHODS
  This prospective study was conducted between November 2012 and November 2015. A total of 40 patients with 67 affected knee joints, having at least 1 year of skeletal growth remaining, were included in the study. Angular correction was measured by recording the mechanical lateral distal femoral angle (mLDFA), mechanical medial proximal tibial angle (mMPTA), and anatomical tibio-femoral angle (TFA) (for the overall alignment of lower limbs). Implant removal was done after 5° of overcorrection was achieved. The rate of correction (° per month) and complications related to each technique were recorded.
  
  
  RESULTS
  The most common diagnosis was idiopathic genu valgum. The overall rate of correction (TFA) was 1.2° for staples and 1.4° for eight plate (p = 0.70, not statistically significant). The correction in mLDFA was statistically better in the eight plate group, whereas an opposite trend was recorded in mMPTA. Implant-related complications were present in two cases of the staples group.
  
  
  CONCLUSIONS
  Although the overall correction rate was similar in both groups, implant-related complications were lower with figure of eight plate. In idiopathic genu valgum (the most common diagnosis), the correction was statistically better in the eight plate group. We recommend figure of eight plate over staples in managing these deformities.
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India. arvindmamc@gmail.com.
authors.forename: Arvind
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sahil
authors.initials: S
authors.lastname: Gaba
authors.affiliation: Department of Orthopaedics, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Alok
authors.initials: A
authors.lastname: Sud
authors.affiliation: Department of Orthopaedics, Bombay Hospital, Mumbai, India.
authors.forename: Pushpvardhan
authors.initials: P
authors.lastname: Mandlecha
authors.affiliation: Department of Orthopaedics, Lady Hardinge Medical College, New Delhi, India.
authors.forename: Lakshay
authors.initials: L
authors.lastname: Goel
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Mayur
authors.initials: M
authors.lastname: Nayak
keywords: Angular deformities around knee; Figure of eight plate; Hemiepiphysiodesis; Staples