Outcomes of Temporary Hemi-Epiphysiodesis Using a New Device for The Treatment of Pediatric Valgus Knee Deformity: A Preliminary Report | ||
The Archives of Bone and Joint Surgery | ||
مقاله 9، دوره 9، شماره 5، آذر و دی 2021، صفحه 536-542 اصل مقاله (724.6 K) | ||
نوع مقاله: RESEARCH PAPER | ||
شناسه دیجیتال (DOI): 10.22038/abjs.2020.49544.2460 | ||
نویسندگان | ||
Mohsen Karami1؛ Adel Ebrahimpour* 1؛ Sohrab Keyhani2؛ Meisam Jafari Kafiabadi3؛ Ramin Etemadi4 | ||
1Department of orthopedics, Taleghani Hospital Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran | ||
2Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran | ||
3Shohada Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran | ||
4Gorgan University of Medical Sciences, Gorgan, Iran | ||
چکیده | ||
Background: This study aimed to evaluate the efficacy of hemi-epiphysiodesis using a new device (X-plate) for the correction of genu valgum. Methods: In total, 22 children with a total of 34 pathologic knee valgus deformities underwent the procedure and were followed up 25.3 months on average. Results: The mean time to clinical correction of genu valgum was 10.9±2.2 months. Furthermore, the mean preoperative anatomic Lateral Distal Femoral Angle (aLDFA) and mechanical Tibia Femoral angle (mTFA) were obtained at 75.1±3.8 and 6±2.8 degrees, respectively. When clinical correction of the deformity was achieved, the mean of aLDFA and mTFA corrections were determined at 8.9±5.3 and 6.5±3.2 degrees, respectively. The mean speed of aLDFA and mTFA corrections were estimated at 0.8±0.45 and 0.6±0.3 degrees per month, respectively. The postoperative aLDFA and mTFA were measured at 84±4.2 and -0.8±2.9 on average. With a mean of 25.3±14.5 months at final follow-up, there were 6 (17.6%) mild valgus knees, 26 (75.5%) normal alignment knees, and only 2 (5.9%) mild varus knee within an acceptable clinical limit. Conclusion: Hemi-epiphysiodesis using X-plate at the distal physis of the femur is an effective and safe method for the treatment of valgus knee deformity in children. Level of evidence: IV | ||
کلیدواژهها | ||
Complication؛ Deformity؛ Genu valgum؛ Temporary hemiepiphysiodesis | ||
مراجع | ||
1. Arazi M, Ö gün TC, Memik R. Normal development of the tibiofemoral angle in children: a clinical study of 590 normal subjects from 3 to 17 years of age. J Pediatr Orthop. 2001;21(2):264–7. 2. De Brauwer V, Moens P. Temporary hemiepiphysiodesis for idiopathic genua valga in adolescents: percutaneous transphyseal screws (PETS) versus stapling. J Pediatr Orthop. 2008;28(5):549–54. 3. Cicuttini F, Wluka A, Hankin J, Wang Y. Longitudinal study of the relationship between knee angle and tibiofemoral cartilage volume in subjects with knee osteoarthritis. Rheumatology. 2004;43(3):321–4. 4. Boero S, Michelis MB, Riganti S. Use of the eight- Plate for angular correction of knee deformities due to idiopathic and pathologic physis: initiating treatment according to etiology. J Child Orthop. Fabry GUY, macewen gd, shands jr ar. torsion of the femur: a follow-up study in normal and abnormal c0nditi0ns. JBJS. 1973;55(8):1726–38. 6. McWalter EJ, Cibere J, MacIntyre NJ, Nicolaou S, Schulzer M, Wilson DR. Relationship between varusvalgus alignment and patellar kinematics in individuals with knee osteoarthritis. JBJS. 2007;89(12):2723–31. 7. Mielke CH, Stevens PM. Hemiepiphyseal stapling for knee deformities in children younger than 10 years: a preliminary report. J Pediatr Orthop. 1996;16(4):423–9. 8. Stevens PM. Guided growth for angular correction: a preliminary series using a tension band plate. J Pediatr Orthop. 2007;27(3):253–9. 9. Mesa PAS, Yamhure FH. Percutaneous hemiepiphysiodesis using transphyseal cannulated screws for genu valgum in adolescents. J Child Orthop. 2009;3(5):397–403. 10. Wiemann IV JM, Tryon C, Szalay EA. Physeal stapling versus 8-plate hemiepiphysiodesis for guided correction of angular deformity about the knee. J Pediatr Orthop. 2009;29(5):481–5. 11. Blount WP, Clarke GR. Control of bone growth by epiphyseal stapling: a preliminary report. JBJS. 1949;31(3):464–78. 12. Haas SL. Retardation of bone growth by a wire loop. JBJS. 1945;27(1):25–36. 13. Boakes JL, Stevens PM, Moseley RF. Treatment of genu valgus deformity in congenital absence of the fibula. J Pediatr Orthop. 1991;11(6):721–4. 14. Bylski-Austrow DI, Wall EJ, Rupert MP, Roy DR, Crawford AH. Growth plate forces in the adolescent human knee: a radiographic and mechanical study of epiphyseal staples. J Pediatr Orthop. 2001;21(6):817–23. 15. Frantz CH. Epiphyseal stapling: a comprehensive review. Clin Orthop Relat Res. 1971;77:149–57. 16. Stevens PM, MacWilliams B, Mohr RA. Gait analysis of stapling for genu valgum. J Pediatr Orthop. 2004;24(1):70–4. 17. Stevens PM, Maguire M, Dales MD, Robins AJ. Physeal stapling for idiopathic genu valgum. J Pediatr Orthop. 1999;19(5):645. 18. Zuege RC, Kempken TG, Blount WP. Epiphyseal stapling for angular deformity at the knee. JBJS. 1979;61(3):320–9. 19. Heath CH, Staheli LT. Normal limits of knee angle in white children--genu varum and genu valgum. J Pediatr Orthop. 1993;13(2):259–62. 20. Cheng JC, Chan PS, Chiang SC, Hui PW. Angular and rotational profile of the lower limb in 2,630 Chinese children. J Pediatr Orthop. 1991;11(2):154–61. 21. Stricker SJ, Faustgen JP. Radiographic measurement of bowleg deformity: variability due to method and limb rotation. J Pediatr Orthop. 1994;14(2):147–51. 22. Cho T-J, Choi IH, Chung CY, Yoo WJ, Park MS, Lee DY. Hemiepiphyseal stapling for angular deformity correction around the knee joint in children with multiple epiphyseal dysplasia. J Pediatr Orthop. 2009;29(1):52–6. 23. Degreef I, Moens P, Fabry G. Temporary epiphysiodesis with Blount stapling for treatment of idiopathic genua valga in children. Acta Orthop Belg. 2003;69(5):426–32. 24. Stewart D, Cheema A, Szalay EA. Dual 8-plate technique is not as effective as ablation for epiphysiodesis about the knee. J Pediatr Orthop. 2013;33(8):843–6. 25. Burghardt RD, Specht SC, Herzenberg JE. Mechanical failures of eight-plateguided growth system for temporary hemiepiphysiodesis. J Pediatr Orthop. 2010;30(6):594–7. 26. Ballal MS, Bruce CE, Nayagam S. Correcting genu varum and genu valgum in children by guided growth: temporary hemiepiphysiodesis using tension band plates. J Bone Joint Surg Br. 2010;92(2):273–6. 27. Jelinek EM, Bittersohl B, Martiny F, Scharfstädt A, Krauspe R, Westhoff B. The 8-plate versus physeal stapling for temporary hemiepiphyseodesis correcting genu valgum and genu varum: a retrospective analysis of thirty five patients. Int orthopaedics. 2012 ;36(3):599-605. 28. Burghardt RD, Herzenberg JE, Standard SC, Paley D. Temporary hemiepiphyseal arrest using a screw and plate device to treat knee and ankle deformities in children: a preliminary report. J Child Orthop. 2008;2(3):187–97. 29. Guzman H, Yaszay B, Scott VP, Bastrom TP, Mubarak SJ. Early experience with medial femoral tension band plating in idiopathic genu valgum. J Child Orthop. 2011;5(1):11–7. 30. Zajonz D, Schumann E, Wojan M, Kübler FB, Josten C, Bühligen U, et al. Treatment of genu valgum in children by means of temporary hemiepiphysiodesis using eight-plates: short-term findings. BMC musculoskeletal disorders. 2017;18(1):456. 31. Aslani H, Panjavy B, Bashy RH, Tabrizi A, Nazari B. The efficacy and complications of 2-hole 3.5 mm reconstruction plates and 4 mm noncanulated cancellous screws for temporary hemiepiphysiodesis around the knee. J J Pediatr Orthop. 2014;34(4):462. 32. Dodwell ER, Garner MR, Bixby E, Luderowski EM, Green DW, Blanco JS, et al. Percutaneous epiphysiodesis using transphyseal screws: a case series demonstrating high efficacy. HSS Journal®. 2017 13(3):255-62. | ||
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