Percutaneous Epiphysiodesis

Canale, S. Terry; Russell, Thomas A.; Holcomb, R. L.

doi:10.1097/01241398-198603000-00006

Cited by 94 publications

(6 citation statements)

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“…Phemister was the first who published an open fusion technique of the growth plate [2]. Over the years, less invasive techniques for irreversible growth arrest have been described and are most commonly performed percutaneously [3, 4]. Potentially reversible epiphysiodesis techniques became more and more popular [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Guided growth with tension band plate or definitive epiphysiodesis for treatment of limb length discrepancy?

et al. 2019

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Background It is not exactly known whether guided growth or definitive epiphysiodesis techniques are superior in treating limb length discrepancy (LLD). The purpose of the present study was therefore to find out if definitive epiphysiodesis is associated with more powerful LLD correction than tension band plate epiphysiodesis. Methods Pediatric patients with LLD treated either with tension band plating as a guided growth technique (temporary epiphysiodesis) or a percutaneous drilling technique (definitive epiphysiodesis) around the knee and a minimum follow-up of 12 months were included in this retrospective study. Radiographic measurements were performed by two independent reviewers. The reduction in side difference between preoperative radiographs and last follow-up was calculated and compared between surgical techniques. Results Thirty-eight patients (mean age 13.6 years) were included, 17 treated with temporary and 21 with definitive epiphysiodesis. Average follow-up was at 578 days. The reduction of the LLD in 12 months was 5.7 mm in patients treated with temporary epiphysiodesis and 8.4 mm with definitive epiphysiodesis, respectively ( p = 0.22). In both groups, LLD could be statistically significantly reduced after 12 and 24 months. Definitive epiphysiodesis had a lower revision rate (4.8% vs. 17.6%). Intra- and interobserver reliability of the measurements was excellent. Conclusions As in earlier studies supposed, temporary epiphysiodesis with tension band plating seems to correct LLD less powerful compared to definitive percutaneous epiphysiodesis. However, in the present study, the differences of LLD correction were not statistically significant. We do not recommend the use of tension band plates for LLD correction due to inferior correction with higher complication and revision rate.

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Section: Introductionmentioning

confidence: 99%

Guided growth with tension band plate or definitive epiphysiodesis for treatment of limb length discrepancy?

et al. 2019

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“…This procedure has disadvantages including considerable and prolonged postoperative care. When Canale et al introduced a minimally invasive technique using power drills to permanently destroy the growth plate it gained popularity [8]. Transphyseal screws are also being used to obtain partial or complete growth arrest, especially in Europe.…”

Section: Methods and Techniques For Guiding Growth In Bonesmentioning

confidence: 99%

Guided growth: Mechanism and reversibility of modulation

Gottliebsen

Shiguetomi-Medina

Rahbek

et al. 2016

Journal of Children's Orthopaedics

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In paediatric orthopaedics, deformities and discrepancies in length of bones are key problems that commonly need to be addressed in daily practice. An understanding of the physiology behind developing bones is crucial for planning treatment. Modulation of the growing bone can be performed in a number of ways. Here, we discuss the principles and mechanisms behind the techniques. Historically, the first procedures were destructive in their mechanism but reversible techniques were later developed with stapling of the growth plate being the gold standard treatment for decades. It has historically been used for both angular deformities and control of overall bone length. Today, tension band plating has partially overtaken stapling but this technique also carries a risk of complications. The diverging screws in these implants are probably mainly useful for hemiepiphysiodesis. We also discuss new minimally invasive techniques that may become important in future clinical practice.

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“…Over the years, open techniques have been gradually replaced by percutaneous techniques, such as the Canale's procedure, because of both aesthetic advantages and fewer postoperative complications [40][41][42].…”

Section: Definitive Epiphysiodesismentioning

confidence: 99%

Growth modulation for angular knee deformities: a practical guideline

Braga

Santili

Rodrigues

et al. 2022

Current Opinion in Pediatrics

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Purpose of reviewThis study aimed to review the established concepts and advances related to growth modulation for treating knee angular deformities. Although they are considered well tolerated procedures, careful indications and accurate techniques are necessary to ensure good results.Recent findingsIn addition to general clinical and radiographic evaluations, new tools such as two-dimensional low-dose radiography and gait analysis have been used to clarify angular and torsional combinations and the impact of mild angulations on the knee joint. Temporary epiphysiodesis is commonly the choice, and it can be performed with different implants such as staples, tension band plates (TBP), percutaneous transphyseal screws (PETS), sutures, and screws.SummaryConsidering its principles, TBP has been preferred for younger children. Cost can be a limitation, and research for alternative implants such as screws and nonabsorbable sutures indicate they might be an alternative in the future. In adolescents, PETS becomes an attractive alternative; however, its reversible character has been controversial, and further studies are needed to establish limits in younger patients.

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Percutaneous Epiphysiodesis

Cited by 94 publications

References 0 publications

Guided growth with tension band plate or definitive epiphysiodesis for treatment of limb length discrepancy?

Guided growth with tension band plate or definitive epiphysiodesis for treatment of limb length discrepancy?

Guided growth: Mechanism and reversibility of modulation

Growth modulation for angular knee deformities: a practical guideline

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