Rotational Guided Growth: A Preliminary Study of Its Use in Children

Torsional malalignment of the legs is common in children, and those that do not remodel may benefit from surgical correction. Traditionally, this is corrected with an open osteotomy. Guided growth is the gold standard for minimally invasive angular correction and has been investigated for use in tor...

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Published inChildren (Basel) Vol. 10; no. 1; p. 70
Main Authors Paley, Dror, Shannon, Claire
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 29.12.2022
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Abstract Torsional malalignment of the legs is common in children, and those that do not remodel may benefit from surgical correction. Traditionally, this is corrected with an open osteotomy. Guided growth is the gold standard for minimally invasive angular correction and has been investigated for use in torsional deformities. This study presents our preliminary results of rotationally guided growth in the femur and tibia using a novel technique of peripheral flexible tethers. A total of 8 bones in 5 patients were treated with flexible tethers consisting of separated halves of a hinge plate (Orthopediatrics Pega Medical, Montreal, QC, Canada), which were fixed to the epiphysis and metaphysis at 45° angles to the physis and connected with Fibertape (Arthrex, Naples, FL, USA). The implants are placed medially and laterally in the opposite 45° inclination, determined by the desired direction of rotation. Additionally, the average treatment time was 12 months. All patients corrected the rotational malalignment by clinical evaluation. The average rotational change was 30° in the femurs and 9.5° in the tibias. Further, the average follow-up was 18 months, with no recurrence of the rotational deformity. There was no change in longitudinal growth in the patients who underwent bilateral treatment. Rotational guided growth with flexible tether devices is a novel technique that successfully corrects torsional malalignment without invasive osteotomy surgery.
AbstractList Torsional malalignment of the legs is common in children, and those that do not remodel may benefit from surgical correction. Traditionally, this is corrected with an open osteotomy. Guided growth is the gold standard for minimally invasive angular correction and has been investigated for use in torsional deformities. This study presents our preliminary results of rotationally guided growth in the femur and tibia using a novel technique of peripheral flexible tethers. A total of 8 bones in 5 patients were treated with flexible tethers consisting of separated halves of a hinge plate (Orthopediatrics Pega Medical, Montreal, QC, Canada), which were fixed to the epiphysis and metaphysis at 45° angles to the physis and connected with Fibertape (Arthrex, Naples, FL, USA). The implants are placed medially and laterally in the opposite 45° inclination, determined by the desired direction of rotation. Additionally, the average treatment time was 12 months. All patients corrected the rotational malalignment by clinical evaluation. The average rotational change was 30° in the femurs and 9.5° in the tibias. Further, the average follow-up was 18 months, with no recurrence of the rotational deformity. There was no change in longitudinal growth in the patients who underwent bilateral treatment. Rotational guided growth with flexible tether devices is a novel technique that successfully corrects torsional malalignment without invasive osteotomy surgery.
Author Paley, Dror
Shannon, Claire
AuthorAffiliation Paley Orthopedic and Spine Institute, West Palm Beach, FL 33407, USA
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  givenname: Claire
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  surname: Shannon
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  organization: Paley Orthopedic and Spine Institute, West Palm Beach, FL 33407, USA
BackLink https://www.ncbi.nlm.nih.gov/pubmed/36670621$$D View this record in MEDLINE/PubMed
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10.1007/978-3-642-59373-4
10.4103/jllr.jllr_6_18
10.2106/JBJS.L.00819
10.1016/j.otsr.2019.06.005
10.1007/s11832-016-0779-8
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Copyright 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.
2022 by the authors. 2022
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Issue 1
Keywords hemiepiphysiodesis
miserable malalignment
femoral anteversion
growth modulation
growth tether
tibial torsion
guided growth
rotational malalignment
Language English
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References Lazarus (ref_9) 2018; 38
Stevens (ref_5) 2007; 27
Stevens (ref_6) 2016; 10
Sawiris (ref_1) 2018; 4
Metaizeau (ref_2) 2019; 105
Cobanoglu (ref_8) 2019; 39
Arami (ref_7) 2013; 95
Staheli (ref_3) 1985; 67
ref_4
Martel (ref_10) 2018; 4
References_xml – volume: 4
  start-page: 1
  year: 2018
  ident: ref_1
  article-title: The Using of “Guided Growth” for Correction of Coronal Deformities around the Knee in Skeletally Immature Children (Systematic Review and Metaanalysis)
  publication-title: Med. Clin. Rev.
  doi: 10.21767/2471-299X.1000073
  contributor:
    fullname: Sawiris
– volume: 67
  start-page: 39
  year: 1985
  ident: ref_3
  article-title: Lower-Extremity Rotational Problems in Children. Normal Values to Guide Management
  publication-title: J. Bone Jt. Surg. Am.
  doi: 10.2106/00004623-198567010-00006
  contributor:
    fullname: Staheli
– volume: 38
  start-page: e97
  year: 2018
  ident: ref_9
  article-title: Torsional Growth Modulation of Long Bones by Oblique Plating in a Rabbit Model
  publication-title: J. Pediatr. Orthop.
  doi: 10.1097/BPO.0000000000001106
  contributor:
    fullname: Lazarus
– volume: 39
  start-page: 289
  year: 2019
  ident: ref_8
  article-title: Effects of Tibial Rotational–Guided Growth on the Geometries of Tibial Plateaus and Menisci in Rabbits
  publication-title: J. Pediatr. Orthop.
  doi: 10.1097/BPO.0000000000001004
  contributor:
    fullname: Cobanoglu
– volume: 27
  start-page: 253
  year: 2007
  ident: ref_5
  article-title: Guided Growth for Angular Correction: A Preliminary Series Using a Tension Band Plate
  publication-title: J. Pediatr. Orthop.
  doi: 10.1097/BPO.0b013e31803433a1
  contributor:
    fullname: Stevens
– ident: ref_4
  doi: 10.1007/978-3-642-59373-4
– volume: 4
  start-page: 97
  year: 2018
  ident: ref_10
  article-title: Rotational-Guided Growth
  publication-title: J. Limb. Lengthen. Reconstr.
  doi: 10.4103/jllr.jllr_6_18
  contributor:
    fullname: Martel
– volume: 95
  start-page: 2022
  year: 2013
  ident: ref_7
  article-title: Guiding Femoral Rotational Growth in an Animal Model
  publication-title: J. Bone Jt. Surg.
  doi: 10.2106/JBJS.L.00819
  contributor:
    fullname: Arami
– volume: 105
  start-page: 1175
  year: 2019
  ident: ref_2
  article-title: New Femoral Derotation Technique Based on Guided Growth in Children
  publication-title: Orthop. Traumatol. Surg. Res.
  doi: 10.1016/j.otsr.2019.06.005
  contributor:
    fullname: Metaizeau
– volume: 10
  start-page: 479
  year: 2016
  ident: ref_6
  article-title: The Role of Guided Growth as It Relates to Limb Lengthening
  publication-title: J. Child. Orthop.
  doi: 10.1007/s11832-016-0779-8
  contributor:
    fullname: Stevens
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StartPage 70
SubjectTerms femoral anteversion
Growth disorders
growth modulation
guided growth
Legs
miserable malalignment
Orthopedics
Pediatrics
rotational malalignment
Surgical techniques
tibial torsion
Transplants & implants
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Title Rotational Guided Growth: A Preliminary Study of Its Use in Children
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