Rotational Guided Growth: A Preliminary Study of Its Use in Children

Paley, Dror; Shannon, Claire

doi:10.3390/children10010070

Cited by 5 publications

(22 citation statements)

References 11 publications

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“…Paley et al ( 14 ) reported achieved rotation in all eight bone segments (five patients) in their study, with an average of 30° in femur and 9.5° in tibia. Seven out of eight segments were corrected with external rotation and one segment was corrected with internal rotation.…”

Section: Resultsmentioning

confidence: 85%

“…A total of 14 studies (10 preclinical ( 3 , 4 , 9 , 10 , 11 , 12 , 17 , 18 , 19 , 20 ), 3 clinical ( 5 , 13 , 14 ), and 1 review ( 16 )) were included that examined guided growth for rotational deformities.…”

Section: Resultsmentioning

confidence: 99%

“…Five ( 4 , 9 , 11 , 12 , 20 ) of the preclinical, in vivo studies reported relevant approval by institutional or ethics committee. For the clinical studies, only Paley et al ( 14 ) reported approval by their institutional review board. Metaizeau et al ( 5 ) and Balslev-Clausen et al ( 13 ) did not report on approval before conducting their studies.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, reference lists of all included studies were screened. Together this resulted in the inclusion of additional seven studies ( 12 , 13 , 14 , 17 , 18 , 19 , 20 ) ( Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

“…As the technique of rotational guided growth now has been reported in clinical case series ( 5 , 13 , 14 ) and may appeal to many clinicians as a safe procedure, the aim of this scoping review was to determine the current body of evidence in the literature and to identify possible knowledge gaps or complications that may warrant caution in implementing this procedure as standard care.…”

Section: Introductionmentioning

confidence: 99%

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Correction of rotational deformities in long bones using guided growth: a scoping review

Halloum,

Kold,

Rölfing

et al. 2024

EFORT Open Reviews

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Purpose The objective of this scoping review was to describe the extent and type of evidence of using guided growth to correct rotational deformities of long bones in children. Methods This scoping review was conducted in accordance with the JBI methodology for scoping reviews. All published and unpublished studies investigating surgical methods using guided growth to perform gradual rotation of long bones were included. Results Fourteen studies were included: one review, three clinical studies, and ten preclinical studies. In the three clinical studies, three different surgical methods were used on 21 children. Some degree of rotation was achieved in all but two children. Adverse effects reported included limb length discrepancy (LLD), knee stiffness and rebound of rotation after removal of tethers. Of the ten preclinical studies, two were ex vivo and eight were in vivo. Rotation was achieved in all preclinical studies. Adverse effects reported included implant extrusions, LLD, articular deformities, joint stiffness and rebound of rotation after removal of tethers. Two of the studies reported on histological changes. Conclusions All studies conclude that guided growth is a potential treatment for rotational deformities of long bones. There is great variation in animal models and surgical methods used and in reported adverse effects. More research is needed to shed light on the best surgical guided growth method, its effectiveness as well as the involved risks and complications. Based on current evidence the procedure is still to be considered experimental. Level of evidence 4

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Section: Resultsmentioning

confidence: 85%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Furthermore, reference lists of all included studies were screened. Together this resulted in the inclusion of additional seven studies ( 12 , 13 , 14 , 17 , 18 , 19 , 20 ) ( Fig. 1 ).…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Correction of rotational deformities in long bones using guided growth: a scoping review

Halloum,

Kold,

Rölfing

et al. 2024

EFORT Open Reviews

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A novel plate design for rotational guided growth: An experimental study in immature porcine femurs

Halloum,

Rahbek,

Gholinezhad

et al. 2024

Journal Orthopaedic Research

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Guided growth for correction of rotational deformities has been reported in several preclinical and clinical studies. Different adverse effects, like growth retardation, articular deformities, and rebound effect have been reported. We have tested a novel plate concept (RotOs PlateTM) intended for the correction of rotational deformities of long bones by guided growth in a porcine model. The plate has sliding screw holes intended to allow for longitudinal growth. Fourteen skeletally immature female pigs were included in the study in a paired design. Mean duration of intervention was 88 days (83–98). CTscans and X‐rays were performed at plate insertion and removal. From the CTscans, 3D‐models of the left and right femora were made and used for measuring the achieved rotation. Three pigs were excluded for reasons not related to the plate design. The plates rotated as intended in all pigs. In two pigs, there was a cut‐out of the proximal screw on the lateral side. Data from these two pigs were included in the results. We observed a mean difference in rotation between the left and right femur of 5.7° in the external direction (CI: 3.7°−7.7°). No statistically significant deformities in the coronal and sagittal plane were observed. The plate worked as intended, that is, the intended rotation was achieved.Clinical SignificanceThis large animal study shows promising results for the feasibility of the method. It is an important first step in validating the technique and detecting possible adverse effects before clinical studies.

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Detorsional guided growth — modern concepts and perspectives of clinical application: a review

Fomylina,

Vilensky,

Lesovaya

et al. 2024

Traumatology and Orthopedics of Russia

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Background. Torsional deformities of the long bones in children are usually treated using correcting detorsional osteotomies with different types of osteosynthesis. However, this method is highly traumatic and can cause severe complications. Guided growth is the gold standard for frontal and sagittal planes deformities treatment in growing children. The technique is effective, minimally invasive, enables early weight-bearing and has lower complication rate. Recently, application of guided growth technique has been actively studied for horizontal plane deformities correction as well. The aim of the review — based on a scientific literature analysis, to present possibilities of using guided growth technique for correcting torsional deformities of the long bones, as well as to define the ways of its improvement for further clinical application. Methods. The search was performed in PubMed/MEDLINE, Google Scholar and eLIBRARY databases. For review, we included 8 articles (five animal experimental studies and three clinical studies), which were published from 2013 to 2023. Results. Analyzed studies demonstrated the possibility of applying detorsional guided growth for horizontal plane deformities correction in growing children. Three main surgical techniques were suggested. Correction efficiency mainly depends on the interplate angle, proper plate positioning and longitudinal growth potential. Limitations of these studies were: a small group number; absence of preoperative CT scans in animal studies; torsional profile measurement using computed tomography was performed only in one of three clinical studies. There was also no preoperative planning of deformity correction/creation amount, so it was not possible to evaluate the accuracy of the suggested methods. The main complications were secondary deformities and limb length discrepancy. Conclusions. Further clinical application of detorsional guided growth in children may be possible after solving the problem of secondary deformities and shortening and providing preoperative planning of the deformity correction amount.

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Rotational Guided Growth: A Preliminary Study of Its Use in Children

Cited by 5 publications

References 11 publications

Correction of rotational deformities in long bones using guided growth: a scoping review

Correction of rotational deformities in long bones using guided growth: a scoping review

A novel plate design for rotational guided growth: An experimental study in immature porcine femurs

Detorsional guided growth — modern concepts and perspectives of clinical application: a review

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