Growth modulation with tension-band plates for the correction of paediatric lower limb angular deformity: current concepts and indications for a rational use

Masquijo, Julio Javier; Artigas, Cristian; Pablos, Julio de

doi:10.1302/2058-5241.6.200098

Cited by 15 publications

(42 citation statements)

References 82 publications

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“…It has been proved that hemiepiphyseal block‐based guided growth technology is an effective treatment for the correction of skeletal malformations in immature children. Compared with supra‐ankle osteotomy, hemiepiphyseal block has the advantages of less trauma, less complications and rapid postoperative recovery 16,22 . At present, hemiepiphyseal block commonly used in distal tibia includes tension band screws and trans‐epiphyseal plate screws.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with supra‐ankle osteotomy, hemiepiphyseal block has the advantages of less trauma, less complications and rapid postoperative recovery. 16 , 22 At present, hemiepiphyseal block commonly used in distal tibia includes tension band screws and trans‐epiphyseal plate screws. Because the trans‐epiphyseal plate screw passes through the epiphyseal plate, it is easy to come with complications such as epiphyseal plate bone bridge and difficulty of removing the screw growing into the bone cortex.…”

Section: Discussionmentioning

confidence: 99%

“…Compared with supra-ankle osteotomy, hemiepiphyseal block has the advantages of less trauma, less complications and rapid postoperative recovery. 16,22 At present, hemiepiphyseal block commonly used in distal tibia includes tension band screws and trans-epiphyseal plate screws.…”

Section: Hemiepiphyseal Block For Ankle Valgusmentioning

confidence: 99%

“…In recent years, a large number of scholars have reported that guided growth technology based on epiphyseal block has achieved satisfactory results in the treatment of knee valgus, ankle valgus and unequal length of both lower extremities in children 11,14,15 . Compared with osteotomy, hemiepiphyseal fixation has the advantages of simple operation, predictability and low complications, so that it has gradually become a popular choice for children's orthopedists 16 . Intramedullary rods or Ilizarov external fixation can be used to improve ankle function, but hemiepiphyseal block is the most favorable method to correct ankle valgus in children with CPT 17 .…”

Section: Introductionmentioning

confidence: 99%

“… 11 , 14 , 15 Compared with osteotomy, hemiepiphyseal fixation has the advantages of simple operation, predictability and low complications, so that it has gradually become a popular choice for children's orthopedists. 16 Intramedullary rods or Ilizarov external fixation can be used to improve ankle function, but hemiepiphyseal block is the most favorable method to correct ankle valgus in children with CPT. 17 The guided growth of distal tibia can not only improve ankle valgus, but also reduce the risk of fracture in patients with CPT.…”

Section: Introductionmentioning

confidence: 99%

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Design of a New “U”‐shaped Staple and Its Clinical Application in Postoperative Ankle Valgus of Congenital Pseudarthrosis of the Tibia in Children

Liu

et al. 2022

Orthopaedic Surgery

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Objective There has been a lack of suitable epiphysis blocking materials due to the characteristics of less tissue coverage and narrow epiphysis in children's distal tibial medial malleolus. Therefore, this study is to investigate the clinical efficacy and safety of a new “U”‐shaped staple in the treatment of postoperative ankle valgus of congenital pseudarthrosis of the tibia (CPT). Method According to the inclusion and exclusion criteria, 33 patients with postoperative ankle valgus of CPT were treated with new “U”‐shaped staples from May 2013 to September 2019. The deformity of ankle valgus was gradually corrected by implanting a new “U”‐shaped staple on the medial side of the distal tibia. Clinical indexes such as the operation time, intraoperative bleeding and hospital stay were observed. Tibiotalar angle was selected as the evaluation index of ankle valgus. American Orthopedic Foot & Ankle Society (AOFAS) scale was used for clinical evaluation of ankle function. The tibiotalar angle, deformity correction rate and complications were evaluated by preoperative, postoperative and last follow‐up imaging data. Student's t‐test was used for statistical analysis. Results Thirty‐three patients, including 12 males and 21 females were included. All the patients were followed up for at least 14 months, with an average of 35 months. The average operation time was 23 (15–40) min, the average amount of intraoperative bleeding was 7.5 (4–10) mL, and the average hospital stay was 4.2 (3–6) days. The intraoperative tibiotalar angles of all patients were 74.2° ± 4.6°, the tibiotalar angle were 86.8° ± 4.9° when internal fixation was removed, and the tibiotalar angles at the last follow‐up were 84.3° ± 5.9°. The average orthopedic rate was 0.68° per month. No patients suffered from serious complications such as screw prolapse, osteomyelitis, wound infection, etc. Postoperative wound pain complications occurred in two patients, which were relieved after conservative treatment. The AOFAS score improved from 46.2 ± 9.4 before the operation to 74.6 ± 5.7 at the last follow‐up (P < 0.01). The ankle movement was good without joint stiffness. There was no epiphyseal plate injury after the removal of internal fixation. Conclusion The new “U”‐shaped staple is characterized by simple implantation, low notch, lower risk of fixation failure and close fitting with cortical bone. It is a safe and effective internal fixation system for the treatment of ankle valgus in children.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Hemiepiphyseal Block For Ankle Valgusmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Design of a New “U”‐shaped Staple and Its Clinical Application in Postoperative Ankle Valgus of Congenital Pseudarthrosis of the Tibia in Children

Liu

et al. 2022

Orthopaedic Surgery

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Growth Modulation for Angular and Length Correction

Stevens

2024

Pediatric Lower Limb Deformities

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Epiphysiodesen und Hemiepiphysiodesen

et al. 2022

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ZusammenfassungDurch das Prinzip der Wachstumsblockade mittels Epiphysiodese und der Wachstumslenkung durch Hemiepiphysiodese können sowohl Beinlängendifferenzen als auch sagittale, koronare und schräge Achsdeformitäten an der unteren Extremität während des Wachstums korrigiert werden. Es werden temporäre und permanente Techniken unterschieden. Der große Vorteil liegt in der minimal-invasiven Anwendung und den geringen Komplikationen. Essenziell sind die genaue Planung sowie das exakte Timing, besonders wenn permanente Verfahren angewandt werden. Die Anwendung rund um das kindliche Kniegelenk kann als Goldstandard der Behandlung von Beinlängendifferenzen und Varus- und Valguskorrekturen bezeichnet werden. Die Wachstumslenkung an der unteren Extremität hat über die letzten Jahre viele neue Einsatzmöglichkeiten an der Hüfte und am Sprunggelenk gefunden. Die erfolgreichen klinischen Ergebnisse mit geringen Komplikationen unterstützen die breite Anwendung der Hemiepiphysiodese und Epiphysiodese am wachsenden Skelett bei Achsfehlstellungen und Beinlängendifferenzen.

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Growth modulation with tension-band plates for the correction of paediatric lower limb angular deformity: current concepts and indications for a rational use

Cited by 15 publications

References 82 publications

Design of a New “U”‐shaped Staple and Its Clinical Application in Postoperative Ankle Valgus of Congenital Pseudarthrosis of the Tibia in Children

Design of a New “U”‐shaped Staple and Its Clinical Application in Postoperative Ankle Valgus of Congenital Pseudarthrosis of the Tibia in Children

Growth Modulation for Angular and Length Correction

Epiphysiodesen und Hemiepiphysiodesen

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