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Hemi epiphysiodesis with 8 Plate for Genu Valgum A case report

SYED BAKHAR S

Abstract


Management of angular deformities around knee in growing children, is always a difficult task. Corrective       osteotomies are associated with pain, stiffness, risk of non union and prolonged period of immobilization. Stapling is associated with high rate of breakage and migration, while epiphysiodesis using transphyseal screw carry the risk of breakage of screws or formation of physeal bar. To overcome these problems the concept of guided growth (hemiepiphysiodesis) using a flexible construct of a                      nonlocking 8 shaped plate with two screws was introduced. This plate acts as a tension band without any risk of direct damage to growth plate. Once the deformity is corrected, plate is removed and the growth is reversible. The procedure is easy, safe and it offers the effective solution for angular deformities around knee. We did hemiepiphysiodesis for a case of bilateral genu valgum in a fourteen year old boy with 8 plate. Deformity was corrected after 18 months and plate was removed.

 


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References


Heath CH, Staheli LT. Normal limits of knee angle in white children. J Pediatr Orthop 1993;13:259.

Green WB. Genu varum and genu valgum in children. In: Schafer M, ed. AAOS Instructional Course Lectures, Vol. 43. Rosemont, IL: American Academy of Orthopaedic Surgeons, 1994:151.

White GR, Mencio GA. Genu valgum in children. Diagnostic and therapeutic alternatives. J Am Acad Orthop Surg 1995;3:275

Pistevos G, Duckworth T: The correction of genu valgum by epiphyseal stapling. J Bone Joint Surg Br 1977; 59:72

Metaizeau JP, Wong-Chung J, Bertrand H, et al: Percutaneous epiphysiodesis using transphyseal screws (PETS). J Pediatr Orthop 1998; 18:363

Mielke CH, Stevens PM: Hemiepiphyseal stapling for knee deformities in children younger than 10 years: A preliminary report. J Pediatr Orthop 1996; 16:423

Bowen JR, Leahey JL, Zhang ZH, et al: Partial epiphysiodesis at the knee to correct angular deformity. Clin Orthop Relat Res 1985; 198:184

Zuege RC, Kempken TG, Blount WP: Epiphyseal stapling for angular deformity at the knee. J Bone Joint Surg Am 1979; 61:320.

Canale ST, Russell TA, Holcomb RL: Percutaneous epiphysiodesis: Experimental study and preliminary clinical results. J Pediatr Orthop 1986; 6:150

Johnston CE, Bueche MJ, Williamson B. Epiphysiodesis for management of lower limb deformities. In: Eilert RE, ed. AAOS Instructional Course, Vol. 41. Rosemont, IL: American Academy of Orthopaedic Surgeons, 1992:437

Wieman JM, Tryon, Szalay:stapling vs 8 plate hemiepiphysiodesis for angular deformities.J.Pediatric Orthop 2009 Jul-Aug29(5)481-5

Stevens PM.Guided growth for angular correction.a preliminary series using tension 8 plate.Pediatric Orthop 2007;27(3)253-9


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