Growth modulation for coronal deformity correction by using Eight Plates—Systematic review

Kumar, Sanjay; Sonanis, S.V.

doi:10.1016/j.jor.2018.01.022

Cited by 42 publications

(50 citation statements)

References 17 publications

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“…In all, 94.06% (95/101) of the genu angular deformities were corrected to standard lower limb alignment (centre of the mechanical axis zone: -1 to 1). Kumar S et al [ 9 ] and Danino B et al [ 15 ] found that the deformities were successfully corrected in 196 out of 215 patients (91.2%, mean age: 9.5 years old) and 342 out of 372 physes (92%, mean age: 12.5 years old), respectively. Our research suggested that younger children with genu angular deformities could have good results when TH surgery is performed using eight-Plate implants.…”

Section: Discussionmentioning

confidence: 99%

“…Temporary hemiepiphysiodesis (TH) has gradually become a widely used procedure for these patients [ 1 , 6 , 7 ]. At present, the eight-Plate implant suggested by Stevens [ 8 ] is the most popular implant used for TH surgery because of the simplicity of the operation, the safety of the implant and the low rate of complications [ 1 , 9 ]. However, most studies advocate delaying TH until 8–10 years of age due to concerns about permanent physeal damage or the occurrence of rebound [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

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Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

Dai

Liang

et al. 2021

BMC Musculoskelet Disord

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Background Temporary hemiepiphysiodesis (TH) using an eight-Plate implant is one of the most common surgeries used for the correction of coronal angular deformities around the knee in adolescents. However, few studies have focused on children aged less than 10 years treated with TH using an eight-Plate implant. The purpose of this study was to investigate the efficacy, correction velocity, and complications of TH with an eight-Plate implant as well as the occurrence of rebound and risk factors in this population. Methods This retrospective study included a total of 135 physes (101 knees) from 66 children (mean age of 4.69 years old, range from 1 to 10 years old) who underwent TH with an eight-Plate implant to correct coronal genu angular deformities in our hospital. Related clinical factors were recorded and analysed by multivariable linear and logistic regression models. Results The mean deformity correction period was 13.26 months, and the mean follow-up after eight-Plate removal was 12.71 months. In all, 94.06% (95/101 knees) of the genu angular deformities were completely corrected. Non-idiopathic genu angular deformity was found to be an independent risk factor for deformity correction failure (odds ratio (OR) = 2.47). The femoral correction velocity was significantly higher than the tibial correction velocity (1.28° vs. 0.83° per month, p < 0.001). After adjustment for other factors, younger children had higher correction velocities in the distal femur; however, genu valgum and idiopathic deformities were associated with higher correction velocities in the proximal tibia. In addition, we found three (3/101, 2.97%) knees with genu valgum that experienced rebound after removal of the eight-Plate, while five (5/101, 4.95%) knees with non-idiopathic genu angular deformity experienced screw loosening. No other complications were found, and non-idiopathic deformity was the only risk factor for complications (OR = 3.96). No risk factor was found for rebound in our study. Conclusions TH using an eight-Plate implant is an effective procedure for coronal genu angular deformities with a low incidence of complications and rebound in patients younger than 10 years old. For this population, TH using an eight-Plate should be considered as soon as the deformity stops responding to conservative treatments. The parents of children younger than 10 years of age with non-idiopathic deformities should be informed preoperatively that the deformity may be prone to correction failure or screw loosening after eight-Plate implantation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

Dai

Liang

et al. 2021

BMC Musculoskelet Disord

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“…In 1933, Phemister described a procedure that made premature physeal closure and arrested the growth plates on both medial and lateral sides of the bone to treat deformity (12,13). Genu valgum is an angular deformity in which the mechanical axis is shifted laterally and commonly presents in children (1,5). Growth modulation is an attractive and accepted method to use in skeletally-immature patients.…”

Section: Discussionmentioning

confidence: 99%

“…Growth modulation is an attractive and accepted method to use in skeletally-immature patients. Besides, it should be employed when failing to reach adequate correction (4,5,14). Temporary hemiepiphysiodesis is an invasive method and the basis of treatments for lower extremity angular deformities (15,16).…”

Section: Discussionmentioning

confidence: 99%

“…enu valgum is a coronal angular deformity of the knee, i.e., frequent in the pediatric group (1)(2)(3)(4). Coronal deformities cause cosmetic problems, pain, functional difficulties in gait patterns, and soft tissue changes (4,5). Genu valgum reasons vary from an idiopathic form and post-traumatic to congenital syndromes and bone dysplasia, like arthrogryposis/vitamin D resistance rickets, and so on (1,6,7).…”

Section: Introductionmentioning

confidence: 99%

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Growth Modulation With Reconstruction Plate for Genu Valgum Deformity in Twins: A Case Report and Literature Review‌

Ghaffari

amini

2020

J. Pediatr. Rev.

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Genu valgum is an angular deformity caused by several reasons, such as congenital syndromes, post-traumatic bone dysplasia, or an idiopathic form. It generates cosmetic problems, difficulties in function, and pain. Manipulating the growth plate by hemiepiphysiodesis with implants helps to achieve the correct alignment. We presented twin girls diagnosed with genu valgum deformity who were suffering from cosmetic problems and pain. We used growth modulation to temporarily arrest the growth plate. This procedure was followed by photographs and after 8 months, the implants were removed without having overcorrection. A brief literature review was also performed concerning the reported cases in the international databases, such as PubMed and Google Scholar on growth modulation for genu valgum deformity in twins. Twin girls with genu valgum deformities underwent hemiepiphysiodesis surgeries. We used reconstruction plates and 3.5 mm non-cannulated screws to fix both the distal femur and proximal tibia to temporarily arrest the growth plate. When we achieved the correct alignment the devices were removed.

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The efficacy of hemiepiphysiodesis for idiopathic knee coronal angular deformity by reconstruction plate and screw: A pilot study

Maleki

Qoreishi

Bisadi

et al. 2023

Health Science Reports

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Background: Angular deformities of the lower extremities are among the most common findings in pediatric orthopedics. Alteration of the mechanical axis in the lower extremity affects the cosmetic appearance and may lead to gait disturbances, knee discomfort, patellar maltracking with or without pain, and early joint osteoarthritis. In the current study, we aimed to investigate the efficacy of 3-hole 3.5 mm reconstruction plates in tension-band temporary hemiepiphysiodesis for correcting idiopathic knee coronal angular deformities. Methods:The surgical procedure was performed using an extraperiosteal tension band plate (a 3-hole reconstruction plate) and two 3.5 mm cortical screws to treat idiopathic knee coronal angular deformity in children. The location of the hemiepiphysiodesis was determined based on the type of angular deformity present.Postoperative follow-ups were conducted through x-rays to measure the medial proximal tibial angle and lateral distal femoral angle of the limbs. Statistical analysis was then performed to evaluate the efficacy of the surgical treatment based on the rate of alignment change exhibited. Results:The study included 14 patients (25 limbs) with genu valgum deformity who underwent temporary hemiepiphysiodesis on both the distal femur and proximal tibia, with 16 proximal tibias and 15 distal femurs being corrected. The correction rate for genu valgum was found to be 0.59°per month for both proximal tibial and distal femoral hemiepiphysiodesis. Six patients (12 limbs) were also identified with genu varum deformity, and the correction rates for proximal tibial lateral hemiepiphysiodesis and distal femoral lateral hemiepiphysiodesis were 0.85°and 0.15°per month, respectively. During a mean follow-up duration of 11 ± 5.7 months, only one case of physeal plate closure was observed, and there were no other significant complications.

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Growth modulation for coronal deformity correction by using Eight Plates—Systematic review

Abstract: Growth modulation with 8-plates has high efficacy and low complications for deformity correction; and has been used widely across all paediatric age groups and aetiology. The literature is mostly retrospective and heterogeneous to develop age and aetiology specific recommendations.

Cited by 42 publications

References 17 publications

Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

Growth Modulation With Reconstruction Plate for Genu Valgum Deformity in Twins: A Case Report and Literature Review‌

The efficacy of hemiepiphysiodesis for idiopathic knee coronal angular deformity by reconstruction plate and screw: A pilot study

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