Assessment of comparative parameters of leg length discrepancy in children using temporary epiphysiodesis with 8-plates

Abstract

BACKGROUND: Epiphysiodesis is used to correct the leg length discrepancy in children. The results of the effectiveness in different studies using epiphysiodesis with 8-plates. Forecasting is a fundamental provision of the methodology to apply epiphysiodesis.
 AIM: To determine the comparative effectiveness of temporary epiphysiodesis with 8-plates in correcting the difference in size of the lower limbs in children, depending on the age of the patient and the segment of epiphysiodesis.
 MATERIALS AND METHODS: We included data from a retrospective analysis of the results of correcting the leg length discrepancy using the method of guided growth in 94 patients. The technique included the use of two 8-plates. The calculation of comparative indicators was used, while the difference in the ratios of lengths of the epiphysiodesed and paired segments before epiphysiodesis and at the time of completion of guided growth (removal of metal structures) was determined as an indicator of the effectiveness of treatment.
 RESULTS: The maximum efficiency was observed with epiphysiodesis of the femur in children of the younger age group (a change of 7.59% in the length of the bone), the minimum was observed with epiphysiodesis of the tibia in children of the older age group (a change in length of 2.04%). The decrease in the effectiveness of femoral epiphysiodesis depending on age was linear, while that between the efficiency indicators in the younger and middle groups was 1.85%, and between the middle and older groups was 2.8%. In epiphysiodesis of the tibia, the difference between the efficiency indicators in the younger and middle age groups was 2.42%, and that between the middle and older age group was 0.34%.
 CONCLUSIONS: Temporary epiphysiodesis with 8-plates is effective in correcting the LLDs in children. The use of the comparative efficiency indicators obtained in different age groups allows us to plan the intervention more accurately and avoid unnecessary operations.

Updates in the Management of Leg Length Discrepancy: A Systematic Review

“…Eight studies including a total of 345 patients -206 (59.7%) of them were males -were included in our data. All of the included studies were retrospective in nature [16][17][18][19][20][21][22][23], five were cohorts [16,17,19,20,23], two were case series [18,21], and one was cross-sectional [22]. Two studies were conducted in the UK [18,19], one in Norway [16], one in Russia [16], one in Poland [20], one in Turkey [21], one in Taiwan [22], and one in China [23].…”

“…The clinical features are displayed in Table 2. Out of the eight studies, six discussed correction surgical interventions [16][17][18][19][20][21] and only two included symptomatic treatments for gait disturbances [22,23].…”

“…Percutaneous epiphysiodesis was the surgical intervention of choice in four studies [16,17,20,21]. Two studies reported using eight-shaped plates, which showed the most effective results [17,21].…”

“…Out of the eight studies, six discussed correction surgical interventions [ 16 - 21 ] and only two included symptomatic treatments for gait disturbances [ 22 , 23 ]. Percutaneous epiphysiodesis was the surgical intervention of choice in four studies [ 16 , 17 , 20 , 21 ]. Two studies reported using eight-shaped plates, which showed the most effective results [ 17 , 21 ].…”

“…Two studies reported using eight-shaped plates, which showed the most effective results [ 17 , 21 ]. LLD can be effectively corrected by temporary epiphysiodesis [ 16 , 17 , 20 , 21 ]. One study reported the incidence of angular deformities following temporary epiphysiodesis [ 16 ].…”