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Published in: Journal of Orthopaedic Surgery and Research 1/2019

Open Access 01-12-2019 | Research article

The effect of temporary hemiepiphysiodesis in the treatment of skeleton immature posttraumatic genu angular deformity: a retrospective study of 27 cases

Authors: Jing Ding, Ting Zhu, Fang-chun Jin, Zhen-kai Wu, Hai Li

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2019

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Abstract

Background

The purpose of this study was to evaluate the effect, rate of angular correction, and complications of temporary hemiepiphysiodesis (TH) in the treatment of skeleton immature posttraumatic genu angular deformity.

Methods

We retrospectively reviewed the records of 27 patients undergoing temporary hemiepiphysiodesis for the management of posttraumatic genu angular deformity. Based on the data from these patients, the rate of correction, effect of correction, length of the lower limbs, and complications were used as the outcome measures.

Results

Outcome measurements were obtained from a chart review of medical records that included information about clinical evaluations. Fifteen boys and 12 girls, with an average age of 6.3 years, were included in the study. The average follow-up was 3.8 years (range, 1.9 to 5.9 years) after surgery. Complete correction was obtained in 24 patients, while partial correction was obtained in 3 patients. The mean rate of angular correction was 8.41°/year in distal femur and 15.19°/year in proximal tibia. One patient had recurrence of genu valgum. No leg length discrepancy was found in our patients.

Conclusion

Temporary hemiepiphysiodesis is a simple, effective, reliable, and reproducible method for the treatment of posttraumatic genu angular deformity, with fewer complications than osteotomy. Nevertheless, it is important to follow the rebound patient closely until skeletal maturity in our future work.
Literature
1.
go back to reference Jordan SE, Alonso JE, Cook FF. The etiology of valgus angulation after metaphyseal fractures in children. J Pediatr OrthopR. 1987;7:450–45.CrossRef Jordan SE, Alonso JE, Cook FF. The etiology of valgus angulation after metaphyseal fractures in children. J Pediatr OrthopR. 1987;7:450–45.CrossRef
2.
go back to reference Jackson DW, Cozen L. Genu valgum as a complication of proximal tibial metaphyseal fractures in children. J Bone Joint Surg. 1971;53:1571–8.CrossRef Jackson DW, Cozen L. Genu valgum as a complication of proximal tibial metaphyseal fractures in children. J Bone Joint Surg. 1971;53:1571–8.CrossRef
3.
go back to reference Zionts LE, MacEwen GD. Spontaneous improvement of post-traumatic tibial valga. J Bone Joint SurgR. 1986;68A:680–6.CrossRef Zionts LE, MacEwen GD. Spontaneous improvement of post-traumatic tibial valga. J Bone Joint SurgR. 1986;68A:680–6.CrossRef
4.
go back to reference Tarr RR, Resnick CT, Wagner KS, et al. Changes in tibiotalar joint contact following experimentally induced tibial angular deformity. Clin Orthop. 1985;199:72–80. Tarr RR, Resnick CT, Wagner KS, et al. Changes in tibiotalar joint contact following experimentally induced tibial angular deformity. Clin Orthop. 1985;199:72–80.
5.
go back to reference Stevens P, MacWilliams B, Mohr A. Gait analysis of stapling for genu valgum. J Pediatr OrthopR. 2004;24(1):70–4.CrossRef Stevens P, MacWilliams B, Mohr A. Gait analysis of stapling for genu valgum. J Pediatr OrthopR. 2004;24(1):70–4.CrossRef
6.
go back to reference Steel H, Sandrow R, Sullivan P. Complications of tibial osteotomy in children for genu valgum or varum. J Bone Joint Surg. 1971;53A:1629–35.CrossRef Steel H, Sandrow R, Sullivan P. Complications of tibial osteotomy in children for genu valgum or varum. J Bone Joint Surg. 1971;53A:1629–35.CrossRef
7.
go back to reference Bowen JR, Leahey JL, Zhang ZH, et al. Partial epiphysiodesis at the knee to correct angular deformity. Clin Orthop. 1985;198:184–90. Bowen JR, Leahey JL, Zhang ZH, et al. Partial epiphysiodesis at the knee to correct angular deformity. Clin Orthop. 1985;198:184–90.
8.
go back to reference Stevens PM. Guided growth for angular correction: a preliminary series using a tension band plate. J Pediatr Orthop. 2007;27:253–9.CrossRef Stevens PM. Guided growth for angular correction: a preliminary series using a tension band plate. J Pediatr Orthop. 2007;27:253–9.CrossRef
9.
go back to reference Raab P, Wild A, Seller K, Krauspe R. Correction of length discrepancies and angular deformities of the leg by Blount’s epiphyseal stapling. Eur J Pediatr. 2001;160:668–74.CrossRef Raab P, Wild A, Seller K, Krauspe R. Correction of length discrepancies and angular deformities of the leg by Blount’s epiphyseal stapling. Eur J Pediatr. 2001;160:668–74.CrossRef
10.
go back to reference Stevens PM, Pease F. Hemiepiphysiodesis for posttraumatic tibial valgus. J Pediatr Orthop. 2006;26:385–92.CrossRef Stevens PM, Pease F. Hemiepiphysiodesis for posttraumatic tibial valgus. J Pediatr Orthop. 2006;26:385–92.CrossRef
11.
go back to reference Stevens PM, Maguire M, Dales MD, et al. Physeal stapling for idiopathic genu valgum. J Pediatr Orthop. 1999;19:645.PubMed Stevens PM, Maguire M, Dales MD, et al. Physeal stapling for idiopathic genu valgum. J Pediatr Orthop. 1999;19:645.PubMed
12.
go back to reference Herring JA. Post-traumatic valgus deformity of the tibia. J Pediatr Orthop. 1981;1:435–9.CrossRef Herring JA. Post-traumatic valgus deformity of the tibia. J Pediatr Orthop. 1981;1:435–9.CrossRef
13.
go back to reference Houghton GR, Rooker GD. The role of periosteum in the growth of long bones. J Bone Joint Surg. 1979;61B:218–420.CrossRef Houghton GR, Rooker GD. The role of periosteum in the growth of long bones. J Bone Joint Surg. 1979;61B:218–420.CrossRef
14.
go back to reference Skak SV. Valgus deformity following proximal tibial metaphyseal fractures in children. Acta Orthop Scand. 1982;53:141–7.CrossRef Skak SV. Valgus deformity following proximal tibial metaphyseal fractures in children. Acta Orthop Scand. 1982;53:141–7.CrossRef
15.
go back to reference Phemister DB. Operative assessment of longitudinal growth of bones in the treatment of deformities. J Bone Joint Surg. 1933;15:1–15. Phemister DB. Operative assessment of longitudinal growth of bones in the treatment of deformities. J Bone Joint Surg. 1933;15:1–15.
16.
go back to reference Bowen JR, Johnson WJ. Percutaneous epiphysiodesis. Clin Orthop. 1984;190:170–3. Bowen JR, Johnson WJ. Percutaneous epiphysiodesis. Clin Orthop. 1984;190:170–3.
17.
go back to reference Blount WP, Clarke GR. Control of bone growth by epiphyseal stapling: a preliminary report. J Bone Joint Surg[Am]. 1949;31:464–78.CrossRef Blount WP, Clarke GR. Control of bone growth by epiphyseal stapling: a preliminary report. J Bone Joint Surg[Am]. 1949;31:464–78.CrossRef
18.
go back to reference Paley D. Principles of deformity correction. Chapter 20. 3rd ed. New York: Springer- Verlag Berlin Heidelberg; 2005. p. 705. Paley D. Principles of deformity correction. Chapter 20. 3rd ed. New York: Springer- Verlag Berlin Heidelberg; 2005. p. 705.
Metadata
Title
The effect of temporary hemiepiphysiodesis in the treatment of skeleton immature posttraumatic genu angular deformity: a retrospective study of 27 cases
Authors
Jing Ding
Ting Zhu
Fang-chun Jin
Zhen-kai Wu
Hai Li
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2019
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-019-1426-0

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