Eight-plate epiphysiodesis

Sinha, Ritesh; Weigl, Daniel; Mercado, Eyal; Becker, Talia; Kedem, Paz; Bar‐On, Elhanan

doi:10.1302/0301-620x.100b8.bjj-2017-1206.r3

Cited by 33 publications

(51 citation statements)

References 17 publications

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“…For the assessment of the proximal tibial articular surface, the medial and lateral slope angles were measured as the angle between the plateau surface and the line between the ends of the physis. 12 , 13 From these measurements the tibial roof angle is calculated by deducting the sum of tibial slope angles from 180° ( Fig. 1 ).…”

Section: Aterials and M Ethodsmentioning

confidence: 99%

“…2A ). 15 In analogy with measurement of the tibial roof angle, 12 we quantified the shape of the distal femur on standing AP radiographs using the ‘femoral floor angle’. This consists of measurements of ‘medial and lateral femur condyle slope angle’, defined as the angle between a line through the ends of the distal femoral physis and the line through the most distal surface of the femoral condyle and the top of the femoral notch.…”

Section: Aterials and M Ethodsmentioning

confidence: 99%

“…In a combined group of angular and leg-length correction cases, Sinha et al observed a ‘volcano’ type deformation of the proximal tibia and raised a concern that this might create an intra-articular deformity of the proximal tibia. 12 This observation was attributed to medial and lateral tethering by the tension-band plates, with ongoing central physeal growth and was most marked in the leg-length correction sub-group. Currently these findings have not been confirmed and no previous analysis has reported on whether a similar articular change occurs on the femoral side of the joint.…”

Section: Introductionmentioning

confidence: 99%

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Tension-band Plating for Leg-length Discrepancy Correction

Calder¹,

Tolk²,

Merchant³

et al. 2022

Strategies in Trauma and Limb Reconstruction

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A bstract Aim Dual tension-band plates are used for temporary epiphysiodesis and longitudinal guided growth. The study aim was to assess rate of correction, to identify development of femoral and tibial intra-articular deformity during correction and to document resumption of growth after plate removal. Materials and methods A retrospective study of 34 consecutive patients treated with dual tension-band plates between 2012 and 2020 was performed. Twenty-four patients had surgery at the distal femur, six at the proximal tibia and four at both. Twenty-five female patients were treated at a mean age of 11.6 (±1.4) years and nine male patients at 13.5 (±1.5) years. Measurements were performed on standardised long-leg radiographs and included leg-length discrepancy (LLD), joint line congruency angle (JLCA), tibial roof angle, femoral floor angle and notch-intercondylar distance. Measurements were taken pre-operatively, at the end of discrepancy correction and at skeletal maturity. Results The LLD reduced by a mean of 12.9 mm (95% CI 10.2–15.5) with the mean residual difference 8.4 mm (95% CI 5.4–11.4). The mean correction rate for the proximal tibia was 0.40 (SD 0.33) mm/month and 0.68 (SD 0.36) mm/month for the distal femur. A significant mean change in residual LLD [−2.5 mm (95% CI −4.2 to −0.7)] was observed between plate removal and skeletal maturity at the femoral level only. After length discrepancy correction, the tibial roof angle showed a significant difference of 8.4° (95% CI 13.4–3.4) between legs. In femoral epiphysiodesis patients, no important differences were observed. Conclusion A significant reduction in LLD can be achieved using dual tension-band plating. A change in intra-articular morphology was observed only in the proximal tibia and not in the distal femur. In the authors’ opinion, tension-band plating is a useful tool for leg-length equalisation but should be reserved for younger patients or when residual growth is difficult to predict. It is one of the management strategies for limb-length difference prior to skeletal maturity. How to cite this article Tolk JJ, Merchant R, Calder PR, et al . Tension-band Plating for Leg-length Discrepancy Correction. Strategies Trauma Limb Reconstr 2022;17(1):19–25.

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Section: Aterials and M Ethodsmentioning

confidence: 99%

Section: Aterials and M Ethodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Tension-band Plating for Leg-length Discrepancy Correction

Calder¹,

Tolk²,

Merchant³

et al. 2022

Strategies in Trauma and Limb Reconstruction

View full text Add to dashboard Cite

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“…An alternative surgical solution was introduced by eight-Plate® implants. The principle of this technique is tethering of the physeal periphery while enabling growth in the rest of the physis [ 13 ]. It is a well-described and established method to correct coronal plane deformities of the knee with minimal complications and has been tested in various studies [ 14 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of temporary epiphysiodesis at the femoral epiphysis using established devices from clinical practice

Struwe

Walter

Druschel

et al. 2021

J Mater Sci: Mater Med

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The aim of this study is to compare biomechanical features of different devices used in clinical routine for temporary epiphysiodesis (eight-Plate® and FlexTackTM). The tested implants were divided into four different groups (eight-Plate® vs. FlexTackTM for lateral and anterior implantation) á 10 samples for testing implanted eight-Plate® vs. FlexTackTM in fresh frozen pig femora for maximum load forces (Fmax) and axial physis distance until implant failure (lmax). A servo hydraulic testing machine (858 Mini Bionix 2) was used to exert and measure reproducible forces. Statistical analyses tested for normal distribution and significant (p < 0.05) differences in primary outcome parameters. There were no significant differences between the eight-Plate® lateral group and the FlexTackTM lateral group for neither Fmax (p = 0.46) nor lmax (p = 0.65). There was a significant higher Fmax (p < 0.001) and lmax (p = 0.001) measured in the eight-Plate® group compared to the FlexTackTM group when implanted anteriorly. In anterior temporary ephiphysiodesis, eight-Plate® demonstrated superior biomechanical stability. At this stage of research, there is no clear advantage of either implant and the choice remains within the individual preference of the surgeon.

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“…Side effects were shape changes of the affected bone areas: For example, widening 11 of the bone circumference in both planes, sagittal and coronary (Figure 2B, yellow arrow), and step formation at bone ends/joints (Figure 2A, green arrow). 12 Mechanically induced growth plate changes consist of a plethora of malformations arranged in parallel in growth plate cartilage and trabecular bone. As a consequence, dysplasia of the physis was found and differed in morphology from the acute phase (thinning; Figure 2D and E) to the recovery phase (thickening, step/spike formation, perturbation/distortion, changes in the cellularity of the layers; Figure 2F).…”

Section: Device-induced Growth Plate Changesmentioning

confidence: 99%

Proceedings of the 2020 Classic Examples in Toxicologic Pathology XXVII

et al. 2021

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The histopathology slide seminar “Classic Examples in Toxicologic Pathology XXVII” was held on February 21 and 22, 2020, at the Department of Pathology at the University of Veterinary Medicine in Hannover, Germany, with joint organization by the European Society of Toxicologic Pathology. The goal of this annual seminar is to present and discuss classical and actual cases of toxicologic pathology. This article summarizes the presentations given during the seminar, including images of representative lesions. Ten actual and classical cases of toxicologic pathology, mostly induced by a test article, were presented. These included small intestine pathology and transcriptomics induced by a γ-secretase modulator, liver findings in nonhuman primates induced by gene therapy, drug-induced neutropenia in dogs, device-induced growth plate lesions, polycystic lesions in CAR/PXR double knockout mice, inner ear lesions in transgenic mice, findings in Beagle dogs induced by an inhibitor of the myeloid leukemia cell differentiation protein MCL1, findings induced by a monovalent fibroblast growth factor receptor 1 antagonist, kidney lesions induced by a mammalian target of rapamycin inhibitor in combination therapy, and findings in mutation-specific drugs.

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Eight-plate epiphysiodesis

Cited by 33 publications

References 17 publications

Tension-band Plating for Leg-length Discrepancy Correction

Tension-band Plating for Leg-length Discrepancy Correction

Biomechanical evaluation of temporary epiphysiodesis at the femoral epiphysis using established devices from clinical practice

Proceedings of the 2020 Classic Examples in Toxicologic Pathology XXVII

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