Comparative study between staples and eight plate in the management of coronal plane deformities of the knee in skeletally immature children

Kumar, Arvind; Gaba, Sahil; Sud, Alok; Mandlecha, Pushpvardhan; Goel, Lakshay; Nayak, Mayur

doi:10.1007/s11832-016-0758-0

Cited by 33 publications

(65 citation statements)

References 17 publications

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“…When pathologic coronal angular deformity around the knee does not resolve spontaneously, or even worsens, surgical intervention is often indicated [ 3 – 5 ]. Temporary hemiepiphysiodesis (TH) has gradually become a widely used procedure for these patients [ 1 , 6 , 7 ]. At present, the eight-Plate implant suggested by Stevens [ 8 ] is the most popular implant used for TH surgery because of the simplicity of the operation, the safety of the implant and the low rate of complications [ 1 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

Dai

Liang

et al. 2021

BMC Musculoskelet Disord

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Background Temporary hemiepiphysiodesis (TH) using an eight-Plate implant is one of the most common surgeries used for the correction of coronal angular deformities around the knee in adolescents. However, few studies have focused on children aged less than 10 years treated with TH using an eight-Plate implant. The purpose of this study was to investigate the efficacy, correction velocity, and complications of TH with an eight-Plate implant as well as the occurrence of rebound and risk factors in this population. Methods This retrospective study included a total of 135 physes (101 knees) from 66 children (mean age of 4.69 years old, range from 1 to 10 years old) who underwent TH with an eight-Plate implant to correct coronal genu angular deformities in our hospital. Related clinical factors were recorded and analysed by multivariable linear and logistic regression models. Results The mean deformity correction period was 13.26 months, and the mean follow-up after eight-Plate removal was 12.71 months. In all, 94.06% (95/101 knees) of the genu angular deformities were completely corrected. Non-idiopathic genu angular deformity was found to be an independent risk factor for deformity correction failure (odds ratio (OR) = 2.47). The femoral correction velocity was significantly higher than the tibial correction velocity (1.28° vs. 0.83° per month, p < 0.001). After adjustment for other factors, younger children had higher correction velocities in the distal femur; however, genu valgum and idiopathic deformities were associated with higher correction velocities in the proximal tibia. In addition, we found three (3/101, 2.97%) knees with genu valgum that experienced rebound after removal of the eight-Plate, while five (5/101, 4.95%) knees with non-idiopathic genu angular deformity experienced screw loosening. No other complications were found, and non-idiopathic deformity was the only risk factor for complications (OR = 3.96). No risk factor was found for rebound in our study. Conclusions TH using an eight-Plate implant is an effective procedure for coronal genu angular deformities with a low incidence of complications and rebound in patients younger than 10 years old. For this population, TH using an eight-Plate should be considered as soon as the deformity stops responding to conservative treatments. The parents of children younger than 10 years of age with non-idiopathic deformities should be informed preoperatively that the deformity may be prone to correction failure or screw loosening after eight-Plate implantation.

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Section: Introductionmentioning

confidence: 99%

Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

Dai

Liang

et al. 2021

BMC Musculoskelet Disord

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“…1-9 The rate of angular correction with hemiepiphysiodesis is an area of interest for many researchers. 10-15 Because clinicians are often faced with angular deformity patients who are approaching skeletal maturity, it may be important to know which technique provides the most effective correction in the shortest amount of time. Stevens (2007) 3 reported a 30% faster rate of correction using the Eight-Plate (Orthofix, Lewisville, Texas) compared with Blount staples (Stryker Howmedica, Kiel, Germany).…”

Section: Introductionmentioning

confidence: 99%

Hemiepiphysiodesis using tension band plates: Does the initial screw angle influence the rate of correction?

Eltayeby

Iobst

Herzenberg

2019

Journal of Children's Orthopaedics

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Purpose When using tension band plates for angular deformity correction, the literature is unclear regarding the most effective screw insertion angle to use. This study evaluates the correlation between initial screw angle and the average rate of correction during hemiepiphysiodesis using tension band plates Methods This retrospective study includes 35 patients (47 physes) with genu valgum deformity (17 idiopathic and 18 fibular hemimelia) who underwent insertion of Eight-Plates between 2010 and 2015. Initial screw angle was determined from the intraoperative fluoroscopic images. Radiographs were obtained within three months of surgery, and follow-up films were obtained every three to six months. Change in mechanical lateral distal femoral angle, medial proximal tibial angle and screw angle was obtained from each follow-up radiograph. Initial screw angle was correlated with the average rate of correction during the entire treatment period. The average rate of angular correction during first and last follow-up periods was also compared. Results The relationship between the initial screw angle and the mean rate of angular correction was not statistically significant (p = 0.2). The rate of angular correction during the first follow-up period (mean of 4.7 months) was 0.86° per month compared with 0.71° per month during the last follow-up period (mean of 5.1 months). Conclusion Application of a tension band plate with a divergence angle ranging from 0° to 30° results in similar rates of angular correction. For surgeons inserting screw-plate tension band devices, there does not seem to be any necessity to make the screws parallel or divergent. We recommend that screw placement be anatomically correct, i.e. not impinging on the physis, rather than favouring any particular divergence angle. Level of evidence IV

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“…Even if our systematic review is similar to some studies 12 ), ( 17 )- ( 19 on the similarities between both techniques, we must address some limitations. First, its high risk of performance, detection, and attrition bias.…”

Section: Discussionmentioning

confidence: 99%

Hemiepiphysiodesis Using Eight-Plate Versus Blount Staple to Correct Genu Valgum and Genu Varum

et al. 2020

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Objective: Our objective is to evaluate whether the use of guided growth with eight-plates is more effective than the use of Blount staples for the correction of the idiopathic genu varum or idiopathic genu valgum. Methods: A systematic review (SR) was carried out according to the appropriate methodology for randomized clinical trials (RCTs). We searched seven databases through a previously defined methodology, and we included RCTs, regardless of language, period of publication and status of publication. Results: Resulted in 6830 articles retrieved. Of theses, we identified 14 potential eligible studies. but just one RCT was included for the SR. The included RCT compares the eight-plate and the Blount staple and showed no statistically significant difference for the outcomes of time to correct the deformity, postoperative pain after 24 hours and postoperative pain after 72 hours. The study is of low or very low level of evidence to determine the most effective technique. We didn’t find a RCT that compared the correction of the genu varum. Conclusion: Good quality randomized clinical trials comparing Blount staples versus eight-plaque must be performed to determine which technique is superior for coronal plane corrections. Level of Evidence I, Systematic review of Level RCTs.

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Comparative study between staples and eight plate in the management of coronal plane deformities of the knee in skeletally immature children

Cited by 33 publications

References 17 publications

Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

Temporary hemiepiphysiodesis using an eight‐plate implant for coronal angular deformity around the knee in children aged less than 10 years: efficacy, complications, occurrence of rebound and risk factors

Hemiepiphysiodesis using tension band plates: Does the initial screw angle influence the rate of correction?

Hemiepiphysiodesis Using Eight-Plate Versus Blount Staple to Correct Genu Valgum and Genu Varum

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