Percutaneous epiphysiodesis for leg length discrepancy

Outcome of Hemiepiphyseal Stapling for Late-Onset Tibia Vara

“…Ideally, anatomic correction occurs concomitant with spontaneous physeal closure at skeletal maturity and staple removal is optional. For patients who are nearly but not yet skeletally mature, have minimal lowerextremity length discrepancy, and have a mechanical axis passing through the center of the knee, percutaneous drilling epiphysiodesis [47][48][49] through the lateral incision can be performed concomitant with staple removal. In patients with substantial remaining growth, as determined by chronological age and the width of the physis on radiographs, overcorrection well into valgus zone 1 was allowed with the anticipation that rebound growth would result in the mechanical axis of the lower extremity passing through the center of the knee at skeletal maturity.…”

Endoscopic-assisted epiphysiodesis

“…Given the improved cosmesis, decreased operative time, and reduced recovery time, percutaneous fluoroscopic-assisted epiphysiodesis has become the recommended method for treating moderate LLD [2,5,7,[10][11][12][13][14]. Multiple studies have demonstrated the efficacy and safety of percutaneous epiphysiodesis since its introduction in the 1980s [5,7,[10][11][12][13][15][16][17][18][19][20][21][22][23][24][25][26][27][28]. Rates of incomplete physeal ablation have been shown to be similar (15%) for both open and percutaneous techniques for epiphysiodesis [23].…”

Guided growth for the treatment of limb length discrepancy

“…A statistically significant difference was noticed in the rate of limb shortening between the stapling and PETS groups, with the former having a better rate of limb length discrepancy correction (P = 0.045). No difference was recorded in preoperative or postoperative limb length discrepancy between the three surgical techniques based on the classification by Kemnitz et al [16] (preoperative: w 2 = 2.51, P = 0.64; postoperative: w 2 = 1.20, P = 0.88; Table 3). …”

“…The radiographic result was considered to be good when the final limb length discrepancy was less than 1.5 cm, fair when it was between 1.5 and 2 cm, and poor when the final limb length discrepancy was more than 2 cm [16].…”