Correction of Coronal Angular Deformity Around Knee Joint in Children Aged Less Than 10 Years by Temporary Epiphysiodesis Using Eight Plate

Document Type : Original Article

Authors

1 Department of Orthopedic Surgery, Shubra Hospital for Health Insurance, Cairo, Egypt.

2 Department of Orthopedic Surgery, Damietta Faculty of Medicine, Al-Azhar University, Damietta, Egypt.

Abstract

Background: Coronal angular deformities in the lower limbs are frequently observed in childhood. Persistent lower limb valgus beyond the age of 8 is not considered physiologic. In skeletally immature children, temporary epiphysiodesis, a relatively minor and typically outpatient surgical procedure, where weight-bearing is usually not restricted, has become an appealing option in pediatric orthopedics.
Aim of Study: The purpose of this research was to assess the effectiveness and safety of  epiphysiodesis in gradually correcting angular knee deformities by temporarily suppressing the physis in skeletally immature patients.
Patients and Methods: A prospective case series design study on twenty patients [21 affected limbs] who presented with angular deformities around their knee joints. These patients were selected from the outpatient clinic of the Faculty of Medicine at Al-Azhar University Hospital in Damietta underwent temporary epiphysiodesis with an eight-Plate implant to correct coronal angular deformities around knee joint. Related clinical and radiological findings were compared preoperatively and at follow up visits [from 6 to 21 months].
Results: The preoperative mean mechanical lateral distal femoral angle [mLDFA] was 84.4° ± 4.68°, increasing to 87.6° ± 3.21° post-operative. The preoperative mean medial proximal tibial angle [MPTA] was 91.2° ± 9.75°, while it decreased to 89.3° ± 3.260 post-operative. The rate of correction was approximately 0.46° per month in the femur and 0.61° per month in the tibia. Of the 20 cases, 19 were fully corrected [95%], 1 was partially corrected and still in progress [5%] with no instances of implant failure were reported.
Conclusion: The use of eight plates for temporary epiphysiodesis in correcting knee angular deformities, in children aged less than 10 years, presents promising results characterized by significant deformity correction and a low complication rate.

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