Long-term results and comparison of the Green-Anderson and multiplier growth prediction methods after permanent epiphysiodesis using Canale's technique

Burger, Kelli N.; Farr, Sebastian; Hahne, Julia; Radler, C; Rudolf, G.

doi:10.1302/1863-2548.13.190024

Cited by 5 publications

(3 citation statements)

References 37 publications

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“…For precise evaluation of bone age, a 6-month interval is usually applied, especially when deciding surgery timing for addressing lower-limb length discrepancies and idiopathic scoliosis. [ 5 , 11 – 14 ] When we calculated the proportion of MAD within 6 months for the 2 methods, the Sauvegrain method showed a higher ratio than the GP method during puberty both in boys ( P < .001) and girls ( P = .223). This might be a natural consequence of the fact that the GP method cannot support several age ranges on a 6-month scale.…”

Section: Discussionmentioning

confidence: 99%

Difference between bone age at the hand and elbow at the onset of puberty

Jang

Ahn

et al. 2022

Medicine

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In the pubertal period, bone age advances rapidly in conjunction with growth spurts. Precise bone-age assessments in this period are important, but results from the hand and elbow can be different. We aimed to compare the bone age between the hand and elbow around puberty onset and to elucidate the chronological age confirming puberty onset according to elbow-based bone age. A total of 211 peripubertal subjects (127 boys and 84 girls) who underwent hand and elbow radiographs within 2 months was enrolled. Two radiologists and a pediatric orthopedic surgeon assessed bone age. Hand bone age was graded using the Greulich–Pyle (GP) method, and elbow bone age was determined using the Sauvegrain method. The correlation of 2 methods was evaluated by Demining regression analysis, and the mean absolute difference (MAD) with chronological age was compared between pre-pubertal and pubertal subjects. Receiver-operating characteristic curve analysis was performed to determine the chronological age confirming puberty onset. There was a statistically significant difference in bone age revealed by the GP and Sauvegrain methods in the pubertal group. In the pubertal group, the MAD was 1.26 ± 0.90 years with the GP method and 0.61 ± 0.47 years with the Sauvegrain method in boys ( P < .001), while in girls, the MAD was 0.84 ± 0.60 years and 0.53 ± 0.36 years with the same 2 methods ( P = .033). The chronological age for confirming puberty onset using the elbow was 12.2 years in boys and 10.3 years in girls. The bone ages of hand and elbow were different at puberty, and the elbow was a more reliable location for bone-age assessment at puberty. Puberty onset according to elbow occurred slightly earlier than expected.

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Section: Discussionmentioning

confidence: 99%

Difference between bone age at the hand and elbow at the onset of puberty

Jang

Ahn

et al. 2022

Medicine

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“…Burger et al reported on results using the Canale epiphysiodesis for idiopathic LLD. They found a mean correction of 13.3 mm (LLD 21.2 mm preoperative and 7.9 mm postoperative) [41]. Ilharreborde et al reported on 45 children with a mean bone age of 12.7 years (range 8.5-15 years) who were treated by PETS.…”

Section: Evidence In Lldmentioning

confidence: 99%

“…reported on results using the Canale epiphysiodesis for idiopathic LLD. They found a mean correction of 13.3 mm (LLD 21.2 mm preoperative and 7.9 mm postoperative) [ 41 ]. Ilharreborde et al.…”

Section: Evidence In Lldmentioning

confidence: 99%

Epiphysiodesis for the treatment of tall stature and leg length discrepancy

Willegger

Schreiner

Kolb

et al. 2021

Wien Med Wochenschr

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SummaryPainful orthopedic conditions associated with extreme tall stature and leg length discrepancy (LLD) include back pain and adopting bad posture. After failure of conservative treatment options, blocking of the growth plates (epiphysiodesis) around the knee emerged as gold standard in patients with tall stature and LLD in the growing skeleton. Surgical planning includes growth prediction and evaluation of bone age. Since growth prediction is associated with a certain potential error, adequate planning and timing of epiphysiodesis are the key for success of the treatment. LLD corrections up to 5 cm can be achieved, and predicted extreme tall stature can be limited. Percutaneous epiphysiodesis techniques are minimally invasive, safe and efficient methods with low complication rates. In general, a multidisciplinary approach should be pursued when treating children and adolescents with tall stature.

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Are percutaneous epiphysiodesis and Phemister technique effective in the treatment of leg-length discrepancy? A systematic review

Tirta,

Hjorth,

Jepsen

et al. 2024

Journal of Pediatric Orthopaedics B

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Epiphysiodesis is considered the preferred treatment for children predicted to have leg length discrepancies (LLDs) 2–5 cm at maturity. The aim of this study was to systematically review the existing literature on the effectiveness of permanent epiphysiodesis for LLD treatment, and secondarily to address the reported complications of permanent epiphysiodesis techniques. This systematic review was performed according to PRISMA guidelines. We searched MEDLINE (PubMed), Embase, Cochrane Library, Web of Science and Scopus for studies on skeletally immature patients with LLD treated with permanent epiphysiodesis. The extracted outcome categories were effectiveness of epiphysiodesis (LLD measurements pre/post-operatively, successful/unsuccessful), physeal fusion/arrest, and complications that were graded on severity. Forty-nine studies (3051 patients) were included, 1550 underwent Phemister/modified Phemister epiphysiodesis and 1501 percutaneous epiphysiodesis (PE). Total successful permanent epiphysiodesis surgeries (16 studies) were 73.7% (516/700). Only 13 out of 23 studies had a mean final LLD of less than 1.5 cm. In total, 17.5% (513/2936) of complications were reported. 57 angular deformities were reported (1.9%). Phemister technique had higher percentage of complications (39%) than PE (19.1%) in total, but when failure to achieve adequate reduction in LLD was not included, complication rates for both were close to 14%. However, severe complications were 10.2% for Phemister group and 5.1% for PE. The high complication rates and the relative low success rate call for optimization of the timing and the applied techniques when treating LLD with permanent epiphysiodesis. Phemister technique was found to have higher percentage of severe complications than PE. Registration: PROSPERO (CRD42023435177).

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Long-term results and comparison of the Green-Anderson and multiplier growth prediction methods after permanent epiphysiodesis using Canale's technique

Cited by 5 publications

References 37 publications

Difference between bone age at the hand and elbow at the onset of puberty

Difference between bone age at the hand and elbow at the onset of puberty

Epiphysiodesis for the treatment of tall stature and leg length discrepancy

Are percutaneous epiphysiodesis and Phemister technique effective in the treatment of leg-length discrepancy? A systematic review

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