Unsuccessful mid-term results for distal humeral hemiepiphysiodesis to treat cubitus varus deformity in young children

Soldado, Francisco; Diaz‐Gallardo, Paula; Cherqaoui, Abdelmounim; Nguyen, Trong-Quynh; Romero-Larrauri, Pablo; Knörr, Jorge

doi:10.1097/bpb.0000000000000950

Cited by 4 publications

(7 citation statements)

References 12 publications

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“…Despite the suboptimal results published in a recent series [ 18 ], we obtained a statistically significant correction of the deformity. It is true, however, that due to the lower growth potential of the distal humerus compared with the other anatomical regions, which accounts for 20% of humerus growth and 10% of limb growth [ 27 , 28 ], the annual correction rate is low, at 2.41° (1.9 to 3.2) for HUA and 1.51° (1.3 to 2.8) when measured by BA.…”

Section: Discussioncontrasting

confidence: 56%

“…There are only three other published papers on guided growth of the lateral distal humerus: two case reports [ 16 , 17 ] and the recent short series of five patients published by Soldado et al [ 18 ] ( Table 3 ). The two case reports use the eight-Plate, as in our study, reporting good results.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, guided growth is less invasive and does not require prolonged immobilization as with corrective osteotomy. However, few recent studies have analyzed this technique applied to the distal humerus for the correction of cubitus varus deformity in children, obtaining uneven results among them [ 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Guided Growth for the Treatment of Cubitus Varus in Children: Medium- to Long-Term Results

Martínez-Álvarez

Galán-Olleros

Alonso-Hernández

et al. 2023

JCM

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Correction of cubitus varus is commonly attempted through supracondylar humeral osteotomy. We hypothesized that lateral distal humeral hemiepiphysiodesis (LDHH) could be used to gradually correct this deformity in children. We conducted a retrospective study including all patients who underwent LDHH with the eight-Plate system between 2008 and 2018, with a minimum 4-year follow-up. We collected demographic, fracture-related, pre- and postoperative clinical (carrying angle (CA), ROM), and radiological data (humeral-ulnar angle (HUA), Baumann angle (BA), shaft-condylar angle (SCA), lateral capitellohumeral angle (LCHA)), as well as data on complications and satisfaction at last follow-up. Fifteen patients were included, with a median follow-up of 81 (64–103) months. All the variables had improved significantly as follows: CA −16 (−18 to −9)°, HUA −16 (−19 to −12)°, BA −11 (−17 to −7)°, SCA 7.5 (3.3 to 13.8)°, LCHA −4.8 (−6.8 to 0.6), flexion 10 (0 to 24)°, and extension 10 (0 to 10)°. The annual correction rate in terms of HUA was 2.41° (1.9 to 3.2). There were 5 cases of aseptic screw loosening, 4 of them requiring replacement, without relation to age at surgery (p = 0.324). Most patients (86.67%) were satisfied, and a relationship was found with younger age at surgery (p = 0.037). In conclusion, preliminary results show that LDHH with the eight-Plate system is an effective technique for mild to moderate cubitus varus deformity correction in children. Patients should be advised of the relatively long duration of implant retention and the possibility of reoperation for screw replacement or implant removal.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

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Guided Growth for the Treatment of Cubitus Varus in Children: Medium- to Long-Term Results

Martínez-Álvarez

Galán-Olleros

Alonso-Hernández

et al. 2023

JCM

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“…Hence, this technique may better serve patients that are near skeletal maturity. Soldado et al [58] used transphyseal crossed cannulated screws (Metaizeau technique) to correct cubitus varus deformities in five very young children. The children had a mean age of 3 years and 7 months and were followed over a mean period of 3 years and 10 months.…”

Section: Hemiepiphysiodesismentioning

confidence: 99%

Indications and Timing of Guided Growth Techniques for Pediatric Upper Extremity Deformities: A Literature Review

Siemensma

Bergen

et al. 2023

Children

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Osseous deformities in children arise due to progressive angular growth or complete physeal arrest. Clinical and radiological alignment measurements help to provide an impression of the deformity, which can be corrected using guided growth techniques. However, little is known about timing and techniques for the upper extremity. Treatment options for deformity correction include monitoring of the deformity, (hemi-)epiphysiodesis, physeal bar resection, and correction osteotomy. Treatment is dependent on the extent and location of the deformity, physeal involvement, presence of a physeal bar, patient age, and predicted length inequality at skeletal maturity. An accurate estimation of the projected limb or bone length inequality is crucial for optimal timing of the intervention. The Paley multiplier method remains the most accurate and simple method for calculating limb growth. While the multiplier method is accurate for calculating growth prior to the growth spurt, measuring peak height velocity (PHV) is superior to chronological age after the onset of the growth spurt. PHV is closely related to skeletal age in children. The Sauvegrain method of skeletal age assessment using elbow radiographs is possibly a simpler and more reliable method than the method by Greulich and Pyle using hand radiographs. PHV-derived multipliers need to be developed for the Sauvegrain method for a more accurate calculation of limb growth during the growth spurt. This paper provides a review of the current literature on the clinical and radiological evaluation of normal upper extremity alignment and aims to provide state-of-the-art directions on deformity evaluation, treatment options, and optimal timing of these options during growth.

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“…Otros autores incluso han demostrado resultados fallidos a medio plazo de la hemiepifisiodesis humeral distal para tratar la deformidad en cúbito varo en niños pequeños. 108 Estos hallazgos estarían relacionados con que el húmero distal tiene una pequeña contribución al crecimiento longitudinal humeral, por lo que la desviación axial o la dismetría pueden no desarrollarse hasta mucho después de la lesión si es que ocurren en absoluto.…”

Section: Reducción Y Fijación Con Tornillo(s) -Dra Carolinaunclassified

Fracturas controvertidas de miembro superior en niños y adolescentes: un debate basado en la evidencia

Taverner¹,

Halliburton²,

Alfaro³

et al. 2022

Revista Mexicana De Ortopedia Pediátrica

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Despite the high incidence of pediatric upper extremity fractures, there is still much debate on optimal management. In a webinar recently organized by the Sociedad Española de Ortopedia Pediátrica (SEOP) in conjunction with the Sociedad Argentina de Ortopedia y Traumatología Infantil (SAOTI), the evaluation and principles of treatment of five controversial upper extremity fractures were discussed. The aim of this special article is to provide readers with a summary of the evidence-based arguments used in that session.

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Unsuccessful mid-term results for distal humeral hemiepiphysiodesis to treat cubitus varus deformity in young children

Cited by 4 publications

References 12 publications

Guided Growth for the Treatment of Cubitus Varus in Children: Medium- to Long-Term Results

Guided Growth for the Treatment of Cubitus Varus in Children: Medium- to Long-Term Results

Indications and Timing of Guided Growth Techniques for Pediatric Upper Extremity Deformities: A Literature Review

Fracturas controvertidas de miembro superior en niños y adolescentes: un debate basado en la evidencia

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