Guided growth for caput valgum in developmental dysplasia of the hip

Peng, Shih-Hui; Lee, Wei-Chun; Kao, Hsuan-Kai; Yang, Wen-E; Chang, Chia‐Hsieh

doi:10.1097/bpb.0000000000000529

Cited by 7 publications

(16 citation statements)

References 20 publications

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“…There are several case series about eccentrical transphyseal screws for coxa valga in patients with developmental dysplasia of the hip and/or cerebral palsy. 44 – 46 To our knowledge there are no reports of the use of TBPs in these patients. Recently d’Heurle et al 47 compared screws, TBPs and drilling techniques for coxa valga in an experimental model with lambs.…”

Section: Correction Of Angular Deformitiesmentioning

confidence: 96%

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

2021

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Growth modulation (GM) with tension-band plates (TBPs) by tethering part of the growth plate is an established technique for the correction of angular deformities in children, and it has increasingly supplanted more invasive osteotomies. Growth modulation with TBPs is a safe and effective method to correct a variety of deformities in skeletally immature patients with idiopathic and pathological physes. The most common indication is a persistent deformity in the coronal plane of the knee exceeding 10°, with anterior and/or lateral joint pain, patellofemoral instability, gait disturbance, or cosmetic concerns. GM has also shown good results in patients with fixed flexion deformity of the knee and ankle valgus. This paper reviews the history of the procedure, current indications, and recent advances underlying physeal manipulation with TBPs. Cite this article: EFORT Open Rev 2021;6:658-668. DOI: 10.1302/2058-5241.6.200098

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Section: Correction Of Angular Deformitiesmentioning

confidence: 96%

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

2021

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“…Previous reports have shown satisfactory radiological results using screw hemi-epiphysiodesis for valgus deformities of the proximal femur secondary to AVN in DDH patients. [11][12][13][14][15] However, there is little in the literature comparing these two surgical procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Later, other studies have shown improved radiological outcomes using the guided growth method. [11][12][13][14] This study is the first to compare guided growth with corrective osteotomy for this particular hip condition. The literature on the management of valgus deformity due to AVN comprises patients already treated by different procedures.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, a varus inclination of the physis has been shown as an early alteration along with screw hemiepiphysiodesis. 14 Previous studies have outlined correction of the caput valgum deformity with a substantial decrease in the HSA after guided growth. [11][12][13][14] As for the neck geometry, Peng et al 14 found no significant difference in the NSA at two years postoperatively.…”

Section: Discussionmentioning

confidence: 99%

“…14 Previous studies have outlined correction of the caput valgum deformity with a substantial decrease in the HSA after guided growth. [11][12][13][14] As for the neck geometry, Peng et al 14 found no significant difference in the NSA at two years postoperatively. In our study, there was a significant decrease in both HSA and NSA in the guided growth group.…”

Section: Discussionmentioning

confidence: 99%

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Guided growth versus varus osteotomy for type II avascular necrosis following surgery for developmental dysplasia of the hip

Hsu

Lee

Lin

et al. 2022

The Bone & Joint Journal

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Aims The aim of this study was to compare outcomes of guided growth and varus osteotomy in treating Kalamchi type II avascular necrosis (AVN) after open reduction and Pemberton acetabuloplasty for developmental dysplasia of the hip (DDH). Methods This retrospective study reviewed patients undergoing guided growth or varus osteotomy for Kalamchi type II AVN between September 2009 and January 2019. All children who had undergone open reduction and Pemberton acetabuloplasty for DDH with a minimum two-year follow-up were enrolled in the study. Demographic and radiological data, which included the head-shaft angle (HSA), neck-shaft angle (NSA), articulotrochanteric distance (ATD), Sharp angle (SA), and lateral centre-edge angle (LCEA) at baseline, two years, and at the extended follow-up, were compared. Revision rates were evaluated. Clinical outcomes using the Harris Hip Score were assessed two years postoperatively. Results A total of 24 patients underwent guided growth and 19 underwent varus osteotomy, over a mean period of 3.3 years (95% confidence interval (CI) 2.8 to 3.8) and 5.2 years (95% CI 4.5 to 6.0), respectively. There were no differences in demographic and preoperative radiological data, except for a younger age at time of acetabuloplasty and larger ATD for the osteotomy group. The HSA did not differ at two years and the extended follow-up because of postoperative rebound in the osteotomy group. The NSA of the osteotomy group remained smaller postoperatively. There were no significant differences in the follow-up ATD, SA, and LCEA, except for a smaller two-year ATD of the osteotomy group. Seven patients (29.2%) in the guided growth group underwent revision surgery and none in the osteotomy group. The Harris Hip Score was similar between groups. Conclusion Guided growth and varus osteotomy had comparable results in improving caput valgum deformity, given the rebound of lateral tilting of the physis after osteotomy correction. There were no differences in clinical outcomes at two years postoperatively. Cite this article: Bone Joint J 2022;104-B(7):902–908.

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Guided Growth Improves Coxa Valga and Hip Subluxation in Children With Hereditary Multiple Exostoses

Hung¹,

Lee

et al. 2022

Journal of Pediatric Orthopaedics

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Background: In children with severe hereditary multiple exostoses (HME), coxa valga, and hip subluxation are common deformities. The literatures related to surgical management and prevention of hip joint subluxation in HME are scarce. In this study, we aimed to investigate the efficacy of guided growth procedure to correct coxa valga and hip subluxation in HME patients. Methods: We retrospectively retrieved 12 patients who received guided growth procedures for coxa valga and hip subluxation in HME patients with proximal femur exostoses with a minimum follow-up time of 2 years between 2012 and 2019. Radiographic parameters include head-shaft angle, Hilgenreiner-epiphyseal angle, acetabular index, Reimer migration percentage, centeredged angle, articulo-trochanteric distance, and femoral neck length for comparison between preoperative and latest follow-up results. It was conducted statistically by paired t test and Wilcoxon signed rank test. Results: In this study, the mean difference between preoperative and latest follow-up was significant in head-shaft angle (12 ± 5 degrees; CI, 10-14; P < 0.001), Hilgenreiner-epiphyseal angle (12 ± 5 degrees; CI, 10-15; P < 0.001), and MP (7% ± 8%; CI, 3-11; P = 0.001). There was a low revision rate (4 of 21, 19%) and no complication in our study. Compared with previous studies on guided growth in children with cerebral palsy and developmental dysplasia of the hip, our study showed good comparable outcomes. Conclusion:The results indicated that guided growth improves the hip radiographic parameters of children with HME and may prevent coxa valga and hip subluxations. It is a safe procedure and provides predictable results.

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Guided growth for caput valgum in developmental dysplasia of the hip

Abstract: Therapeutic study, level IV.

Cited by 7 publications

References 20 publications

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

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

Guided growth versus varus osteotomy for type II avascular necrosis following surgery for developmental dysplasia of the hip

Guided Growth Improves Coxa Valga and Hip Subluxation in Children With Hereditary Multiple Exostoses

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