Guided growth: Preliminary results of a multinational study of 967 physes in 537 patients

• Published in: Journal of children's orthopaedics Vol. 12; no. 1; pp. 91 - 96
• Main Authors: Danino, B., Rödl, R., Herzenberg, J. E., Shabtai, L., Grill, F., Narayanan, U., Segev, E., Wientroub, S.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.02.2018; Sage Publications Ltd; The British Editorial Society of Bone & Joint Surgery
• Subjects: Age; Congenital diseases; Etiology; Infections; Metabolism; Original Clinical; Orthopedics; Patients; Pediatrics; Rickets; Success; Surgeons; Surgery; hemiepiphysiodesis; complications; limb deformity; guided growth
• ISSN: 1863-2521; 1863-2548
• DOI: 10.1302/1863-2548.12.170050

Background Guided growth by tension band plating is commonly used to correct coronal plane deformity. The purpose of this study was to measure the effect and further define parameters that influence results in coronal plane deformity around the knee. Methods The retrospective multicentre study included data on 967 physes in 537 patients, with an average follow-up of 16 months after plate insertion. Alignment analysis was compared preoperatively and in at least two measurements postoperatively, as well as with parameters that influence the rate and amount of correction. Results Average age at plate implantation was 11.35 years (SD 3.29). Of those with femoral deformities, 85% of the patients finished the treatment and of those, 70% were corrected to standard alignment, while 14% have not yet achieved correction, and are still growing. Of those with tibial deformities, 75% of the patients finished the treatment and of those 80% were corrected to standard alignment, while 25% have not yet achieved correction and are still growing. The calculated rate of correction was 0.77°/month for the femur and 0.79°/month for the tibia. In terms of complications, the overall rate of infection was 1.48%. In three patients (0.55%) screw breakage was recorded. Factors found to significantly influence the amount of correction were age at plate implantation and direction of deformity. Conclusion Temporary hemiepiphysiodesis takes the advantage of physiological physeal growth to effectively treat angular deformities. Success of treatment is influenced by the age of the patient at plate implantation and direction of deformity. Level of Evidence IV