Expanded Indications for Guided Growth in Pediatric Extremities

Abstract

Guided growth for coronal plane knee deformity has successfully historically been utilized for knee valgus, and knee varus. More recent use of this technique has expanded its indications to correct other lower and upper extremity deformities such as hallux valgus, hindfoot calcaneus, ankle valgus and equinus, rotational abnormalities of the lower extremity, knee flexion, coxa valga, and distal radius deformity. Guiding the growth of the extremity can be successful and is a low morbidity method for correcting deformity and should be considered early in the treatment of these conditions, when the child has a minimum of 2 years of growth remaining. Further expansion of the application of this concept in the treatment of pediatric limb deformities should be considered

Guided Growth of the Proximal Femur for the Management of the ‘Hip at Risk’ in Children with Cerebral Palsy—A Systematic Review

“…Implant choice varied considerably amongst all authors, ranging from 4.5 to 7.0 mm screw, both fully or partially threaded; however, it remains unclear if complications, including the screw backing out, are associated with the implant choice. Furthermore, it was recommended to pass two or three screw threads past the physis into the epiphysis [57], and Hsu et al [48] have concluded that a centered screw position within the physis is associated with a reduced risk for physis growing off. The authors have suggested a centred screw position in young children, where early re-operation surgery i.e.…”

Insertion of One-third Tubular Plate for Hemiepiphysiodesis in Children: Surgical Technique

“…Limb length discrepancy and angular deformity are common in children. In cases when the physis is still open with the remaining growth of more than two years, the treatment of these two conditions with growth modulation is famous among paediatric surgeons [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Less invasive, immediate weight-bearing, avoiding or delaying more invasive surgeries, early rehabilitation and minor and fewer reported morbidities are the advantages of the guided growth compared to bone lengthening or corrective osteotomy for limb length discrepancy and angular deformity, respectively [1-10, 12-15, 18].…”