The Effect of Temporary Hemiepiphyseal Stapling on the Growth Plate

Aykut, Ümit Selçuk; Yazıcı, Muharrem; Kandemir, Utku; Gedikoğlu, Gökhan; Aksoy, M. Ataman; Çil, Akın; Surat, Adil

doi:10.1097/01.bpo.0000152906.23669.d8

Cited by 40 publications

(36 citation statements)

References 27 publications

(32 reference statements)

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“…staples or percutaneous screws (PETS) is awaiting further study [27]. We have undertaken research in New Zealand rabbits to elucidate the response of the physis to flexible vs .…”

Section: Discussionmentioning

confidence: 99%

Guided growth: 1933 to the present

Stevens¹

2006

Strategies in Trauma and Limb Reconstruction

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While osteotomies are necessary for rotational correction and limb lengthening, angular correction or moderate length inhibition may be achieved by other, less invasive means. Several techniques of epiphysiodesis have evolved, enabling gradual correction of angular correction and/or length equalisation through guided growth. This manuscript comprises a historical and comparative review of those techniques. The 8-plate method of guided growth affords the opportunity to provide a tension band (rather than compression) that expedites angular correction, compared to stapling or transphyseal screws, which rely upon the principle of compression. When applied to each side of a given physis, longitudinal growth is inhibited, in the same fashion as stapling or epiphysiodesis. The physis and periosteum are spared any direct insult, thus making this a reversible process, suitable for use in younger children. The 8-plate is simple to insert and, compared to staples or transphyseal screws, easy to remove.

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“…staples or percutaneous screws (PETS) is awaiting further study [27]. We have undertaken research in New Zealand rabbits to elucidate the response of the physis to flexible vs .…”

Section: Discussionmentioning

confidence: 99%

Guided growth: 1933 to the present

Stevens¹

2006

Strategies in Trauma and Limb Reconstruction

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“…He proposed the use of three staples, suggesting that this was the ideal construct to maximize the correction while minimizing the risk of hardware failure. Blount also observed that, after removing the staples, the physis recovered its ability for continued growth [3, 8, 9]. This is in contrast to methods typically performed near the end of growth which cause complete, irreversible growth arrest [9, 10].…”

Section: Introductionmentioning

confidence: 99%

Early experience with medial femoral tension band plating in idiopathic genu valgum

Guzmán

Yaszay

Scott

et al. 2011

Journal of Children's Orthopaedics

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PurposeFor correction of angular deformity, tension band plating has been proposed as a safe and minimally invasive technique. The purpose of this study was to assess the experiences and report the rate of correction obtained with this procedure in patients with idiopathic genu valgum.MethodsThis study was a retrospective review of 47 valgus deformities of the knee treated with medial hemiepiphysiodesis using a tension band plate. The tibiofemoral angle (TFA) and the anatomic lateral distal femoral angle (aLDFA) were assessed on anteroposterior (AP) radiographs of the lower extremity taken at multiple time intervals. The values were charted to determine the change in orientation of the joint surface over time. Pearson’s correlation was used to analyze the correction over time. A subanalysis was performed evaluating the effect of age and the number of plates utilized.ResultsA total of 47 deformities in 25 patients were reviewed. The average time of follow-up from index surgery was 12.7 months, with an average correction of 0.96° every 3 months or 3.8° per year. The aLDFA corrected at a faster rate in knees with two plates per hemiepiphysiodesis than those with one plate, 4.2° and 3.3° per year, respectively (P = 0.035). Girls <11 years of age and boys <13 years of age corrected at a rate of 4.5°, while older children corrected at a rate of 3.4° per year (P = 0.39). There were no complications or instrumentation breakages.ConclusionHemiepiphysiodesis with tension band plating provides an effective and predictable correction of idiopathic genu valgum. Two plates appear to provide a greater rate of correction. There is also a trend toward faster correction in younger patients as well.

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“…The technique requires an open approach, and care should be taken to avoid damaging the periosteum, the perichondrial ring, and epiphyseal vessels. The latter may result in iatrogenic permanent physeal arrest or, in contrast, rebound overgrowth [17][18][19]. When hemiepiphyseal stapling was compared with PETS for the correction of angular deformities, no significant difference was observed in the mean rate of angular correction, the physeal behavior after implant removal, or the number of complications [12].…”

Section: Discussionmentioning

confidence: 77%

Guided growth for the treatment of limb length discrepancy

Lykissas

Jain

Manickam

et al. 2013

Journal of Pediatric Orthopaedics B

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The purpose of this study was to compare the safety and effectiveness of three mechanical devices (percutaneous transphyseal screws, tension band plates, and staples) for the correction of limb length discrepancies in growing children and adolescents. Thirty-nine consecutive patients treated with epiphysiodesis for limb length discrepancy were retrospectively reviewed. No significant difference was recorded between the three devices in postoperative limb length discrepancy or the rate of correction between the plating and stapling groups and between plating and percutaneous transphyseal screws groups. Epiphysiodesis for length discrepancies can be performed effectively using staples, tension band plates, or percutaneous transphyseal screws.

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The Effect of Temporary Hemiepiphyseal Stapling on the Growth Plate

Cited by 40 publications

References 27 publications

Guided growth: 1933 to the present

Guided growth: 1933 to the present

Early experience with medial femoral tension band plating in idiopathic genu valgum

Guided growth for the treatment of limb length discrepancy

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