Guided Growth for Ankle Valgus

Stevens, Peter M.; Kennedy, Jason; Hung, Man

doi:10.1097/bpo.0b013e318236b1df

Cited by 66 publications

(73 citation statements)

References 21 publications

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“…Both are safe, minimally invasive, simple procedures that can be performed on an outpatient basis without postoperative immobilization or weight-bearing restrictions. [2][3][4] In addition, both techniques have been shown to provide adequate correction of valgus deformity and are reversible, allowing for resumption of medial physeal growth after hardware removal if adequate correction is achieved before skeletal maturity. [2][3][4] No prior study has compared outcomes of patients treated with MMS to those of patients treated with TBP for ankle valgus deformity to explore relative advantages and disadvantages of each alternative.…”

Section: Discussionmentioning

confidence: 97%

“…1 Surgical treatment options have historically included Achilles-fibular tenodesis, 9 transphyseal 10 or supramalleolar tibial osteotomy, 8 and permanent or temporary hemiepiphysiodesis using transphyseal staples, 11 MMSs, 2,3 and, more recently, TBPs. 4 Temporary hemiepiphysiodesis using either MMS or TBP techniques affords several advantages when compared with earlier techniques. Both are safe, minimally invasive, simple procedures that can be performed on an outpatient basis without postoperative immobilization or weight-bearing restrictions.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4] All procedures were performed under general anesthesia with patients positioned supine on a radiolucent table. If the distal tibial medial hemiepiphysiodesis was performed in isolation, it was done on an outpatient basis, limbs were not immobilized, and activities as tolerated were permitted immediately after surgery.…”

Section: Surgical Techniquementioning

confidence: 99%

See 2 more Smart Citations

Medial Malleolar Screw Versus Tension-band Plate Hemiepiphysiodesis for Ankle Valgus in the Skeletally Immature

Driscoll

Linton

Sullivan

et al. 2014

Journal of Pediatric Orthopaedics

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Medial Malleolar Screw Versus Tension-band Plate Hemiepiphysiodesis for Ankle Valgus in the Skeletally Immature

Driscoll

Linton

Sullivan

et al. 2014

Journal of Pediatric Orthopaedics

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“…Supramalleolar distal tibia osteotomy to correct ankle valgus is considered to be the least attractive treatment option, since recurrent pseudarthrosis may develop in up to 50 % of the patients after this procedure [3]. Hence, ankle valgus should probably be addressed by a medial hemi-epiphysiodesis at an appropriate time, a technique which is described as being effective for a variety of congenital conditions [32].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology and treatment outcome of congenital pseudarthrosis of the tibia

Horn

Steen

Terjesen

2013

Journal of Children's Orthopaedics

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Purpose Congenital pseudarthrosis of the tibia (CPT) is a rare disease. Epidemiological data are limited, and treatment of the condition is challenging. The purpose of our study was to gain epidemiological data on the incidence of CPT in Norway and to evaluate the treatment outcome of the disease. Methods During the period 1987–2006 22 patients with CPT were born in Norway (11 boys, 11 girls; mean age 15 years, age range 8–24 years) and are included in this study. During the same time period 1,183,380 live-births were registered by the Norwegian Birth Register. Primary surgical treatment was the Ilizarov method in 15 patients, intramedullary nailing in three patients, and plate osteosynthesis in two patients; two patients never developed a fracture and were treated with an orthosis. Results The incidence of CPT based on this period was 1:53,000. The rate of primary healing was 66 % for the Ilizarov group. Primary healing occurred in three patients treated with intramedullary nailing and in none of the patients treated with plate osteosynthesis. However, almost all patients required additional surgery due to refracture or deformity correction. Currently, all 12 skeletally mature patients are considered to be healed, whereas two of the skeletally immature patients are still under treatment. Conclusion The incidence of CPT in Norway seems to be notably higher than that based on epidemiological data from other studies. Primary healing rates are satisfactory when treated either with an Ilizarov device or intramedullary nailing. Refractures must be avoided, and alignment of the leg must be maintained. Healing is usually achieved before skeletal maturity. However, residual deformities are common.

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“…[39][40][41] In addition, AP, medial oblique (MO), and lateral WB ankle films of the contralateral ankle are ordered to determine optimal fibular length and rotation. In the normal ankle, the tip of the lateral malleolus is 3 to 4 mm lower than that of the medial malleolus; the Shenton line is intact, and the "dime sign" is present at the lateral malleolar tip.…”

Section: Surgical Techniquementioning

confidence: 99%