TY - JOUR
T1 - Use of the eight-Plate for angular correction of knee deformities due to idiopathic and pathologic physis
T2 - Initiating treatment according to etiology
AU - Boero, Silvio
AU - Michelis, Maria Beatrice
AU - Riganti, Simone
PY - 2011/6
Y1 - 2011/6
N2 - Purpose: Angular deformities of the knee resulting from idiopathic, congenital, or acquired causes are commonly encountered in pediatric orthopedics. Whereas physiological deformities should be treated expectantly, the remaining often progress enough to warrant operative treatment, despite attempted bracing. Historical methods of surgical treatment (e. g., epiphysiodesis and stapling) have yielded to the increasingly popular method of reversible guided growth using the eight-Plate. Methods: We studied 58 patients with knee angular deformities managed with eight-Plate guided growth. All etiologies except physiological deformities and those with very slow growth rate were included. Each patient was under appropriate medical management during the entire duration of treatment and after plate removal. Results: In the dysplasia/syndrome group, we noted complete correction in 22 patients (78.5%), partial correction in 5 (17.9%), and no correction in 1 patient (3.6%). All cases of idiopathic deformities resolved. Patients with osteochondral dysplasias and genetic syndromes underwent earlier intervention and slower correction than those with idiopathic genu varum or valgum. The time difference in reaching a neutral mechanical axis between the two groups (11 months in idiopathic versus 18 months in pathological physis) could be explained by a significant difference in growth speeds (P = 0.003). Conclusion: Results indicate that early intervention is advisable for patients with osteochondral dysplasias/syndromes as subsequent correction takes longer. If rebound growth causing recurrent deformity occurs, guided growth can be safely repeated. Additionally, complications reported with other techniques such as hardware failure, physeal violation by the implant, premature physeal closure, and overcorrection were not reported while using the eight-Plate.
AB - Purpose: Angular deformities of the knee resulting from idiopathic, congenital, or acquired causes are commonly encountered in pediatric orthopedics. Whereas physiological deformities should be treated expectantly, the remaining often progress enough to warrant operative treatment, despite attempted bracing. Historical methods of surgical treatment (e. g., epiphysiodesis and stapling) have yielded to the increasingly popular method of reversible guided growth using the eight-Plate. Methods: We studied 58 patients with knee angular deformities managed with eight-Plate guided growth. All etiologies except physiological deformities and those with very slow growth rate were included. Each patient was under appropriate medical management during the entire duration of treatment and after plate removal. Results: In the dysplasia/syndrome group, we noted complete correction in 22 patients (78.5%), partial correction in 5 (17.9%), and no correction in 1 patient (3.6%). All cases of idiopathic deformities resolved. Patients with osteochondral dysplasias and genetic syndromes underwent earlier intervention and slower correction than those with idiopathic genu varum or valgum. The time difference in reaching a neutral mechanical axis between the two groups (11 months in idiopathic versus 18 months in pathological physis) could be explained by a significant difference in growth speeds (P = 0.003). Conclusion: Results indicate that early intervention is advisable for patients with osteochondral dysplasias/syndromes as subsequent correction takes longer. If rebound growth causing recurrent deformity occurs, guided growth can be safely repeated. Additionally, complications reported with other techniques such as hardware failure, physeal violation by the implant, premature physeal closure, and overcorrection were not reported while using the eight-Plate.
KW - Eight-Plate
KW - Guided growth
KW - Hemiepiphysiodesis
KW - Knee angular deformities
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U2 - 10.1007/s11832-011-0344-4
DO - 10.1007/s11832-011-0344-4
M3 - Article
C2 - 22654982
AN - SCOPUS:79957596747
VL - 5
SP - 209
EP - 216
JO - Journal of Children's Orthopaedics
JF - Journal of Children's Orthopaedics
SN - 1863-2521
IS - 3
ER -