scholarly journals Change in Effective Leg Length after Angular Deformity Correction by Hemiepiphyseal Stapling

2010 ◽  
Vol 2 (2) ◽  
pp. 85 ◽  
Author(s):  
Ho-Joong Jung ◽  
Tae-Joon Cho ◽  
In Ho Choi ◽  
Chin Youb Chung ◽  
Won Joon Yoo ◽  
...  
Keyword(s):  
Deformity Correction ◽  
Angular Deformity ◽  
Leg Length

scholarly journals 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

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Zhen-Zhen Dai ◽  
Zhen-Peng Liang ◽  
Hao Li ◽  
Jing Ding ◽  
Zhen-Kai Wu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Deformity Correction ◽  
Genu Valgum ◽  
Angular Deformity ◽  
Screw Loosening ◽  
Logistic Regression Models ◽  
The Mean ◽  
Low Incidence ◽  
Angular Deformities

Abstract 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.

Single time angular deformity correction and treatment of knee instability in congenital fibular hemimelia. A case report

The Knee ◽  
2012 ◽  
Vol 19 (4) ◽  
pp. 504-507 ◽  
Author(s):  
David Figueroa ◽  
Rafael Calvo ◽  
Ignacio E. Villalón ◽  
Andrés Schmidt-Hebbel ◽  
Francisco Figueroa ◽  
...  
Keyword(s):  
Case Report ◽  
Deformity Correction ◽  
Knee Instability ◽  
Angular Deformity ◽  
Single Time ◽  
Fibular Hemimelia

scholarly journals Long term results after transepiphysal ACL reconstruction in children and adolescent

2018 ◽  
Vol 6 (4_suppl2) ◽  
pp. 2325967118S0001
Author(s):  
Christian Eberle ◽  
Wolfgang Schopf ◽  
Andree Ellermann
Keyword(s):  
Acl Reconstruction ◽  
Cartilage Damage ◽  
Long Term Results ◽  
Angular Deformity ◽  
Leg Length ◽  
Growth Disturbance ◽  
Children And Adolescent ◽  
The Mean

The aim of our study was to review the long term clinical and radiological (MRI) outcomes of adult patients who underwent ACL reconstruction as children or adolescent with emphasize to the features of growth disturbance, angular deformity, meniscal and cartilage damage and revision rate We retrospectively evaluated patient who underwent ACL reconstruction in our clinic with arthroscopic transepiphyseal technique using hamstrings graft in childhood or adolescence between the years 1997 and 2009. A total of 43 Patients were assessed. 25 male and 18 female. The average age at time of surgery was 13,5 years (8 - 16 y.), at time of assessement 22,4 years (18 - 30 y.) . The mean follow up was 10 years (4 - 16 years). The physical development of the patients was assessed with the Lysholm score and the Cincinnati Knee score scale, their satisfaction was recorded on the basis of the IKDC subjective knee evaluation form and the Tegner activity score . Leg deformity or leg length discrepancy was evaluated clinically by the observers. The instrumented Lachman test using KT1000 and manual Pivot shift test was performed to assess knee stability. MRI was used to detect graft integrity, cartilage and meniscal damages. No significant leg deformities or leg length discrepancy had been detected. The average Lysholm score was 91 points (83 - 100), the Cincinnati Knee Score was 90,4 (79 - 100) points on average . The mean IKDC score was 92 points (82 -100). The Tegner-Activity-Score changed from preop 6,8 (2-10) to post op 5,8 (2-9). 2 Patient underwent revision ACL reconstruction due to rerupture (3 and 9 years post op). 2 Patients underwent meniscal surgery during follow up (1 resection and one refixation). KT1000 evaluation showed 67% excellent, 21% good and in 12% bad results. The MRI scan showed 42 intact grafts and one unverifiable graft. One patient with cartilage damage up to 3° (ICRS), 3 patients with meniscal degeneration up to grade 2. Each patient showed a free range of motion Our data underlines that transepiphyseal ACL reconstruction in children and adolescent with hamstrings is a save procedure leading to good long term results without causing angular deformity or growth disturbance

scholarly journals The effect of temporary hemiepiphysiodesis in the treatment of skeleton immature posttraumatic genu angular deformity: a retrospective study of 27 cases

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Jing Ding ◽  
Ting Zhu ◽  
Fang-chun Jin ◽  
Zhen-kai Wu ◽  
Hai Li
Keyword(s):  
Skeletal Maturity ◽  
Lower Limbs ◽  
Angular Deformity ◽  
Leg Length ◽  
Clinical Evaluations ◽  
Angular Correction ◽  
Reproducible Method ◽  
Future Work ◽  
Partial Correction

Abstract Background The purpose of this study was to evaluate the effect, rate of angular correction, and complications of temporary hemiepiphysiodesis (TH) in the treatment of skeleton immature posttraumatic genu angular deformity. Methods We retrospectively reviewed the records of 27 patients undergoing temporary hemiepiphysiodesis for the management of posttraumatic genu angular deformity. Based on the data from these patients, the rate of correction, effect of correction, length of the lower limbs, and complications were used as the outcome measures. Results Outcome measurements were obtained from a chart review of medical records that included information about clinical evaluations. Fifteen boys and 12 girls, with an average age of 6.3 years, were included in the study. The average follow-up was 3.8 years (range, 1.9 to 5.9 years) after surgery. Complete correction was obtained in 24 patients, while partial correction was obtained in 3 patients. The mean rate of angular correction was 8.41°/year in distal femur and 15.19°/year in proximal tibia. One patient had recurrence of genu valgum. No leg length discrepancy was found in our patients. Conclusion Temporary hemiepiphysiodesis is a simple, effective, reliable, and reproducible method for the treatment of posttraumatic genu angular deformity, with fewer complications than osteotomy. Nevertheless, it is important to follow the rebound patient closely until skeletal maturity in our future work.

scholarly journals Posteromedial bowing of the tibia: a benign condition or a case for limb reconstruction?

2018 ◽  
Vol 12 (2) ◽  
pp. 187-196 ◽  
Author(s):  
J. Wright ◽  
R. A. Hill ◽  
D. M. Eastwood ◽  
A. Hashemi-Nejad ◽  
P. Calder ◽  
...  
Keyword(s):  
Treatment Options ◽  
Case Series ◽  
Deformity Correction ◽  
First Year ◽  
Leg Length ◽  
Level Of Evidence ◽  
Benign Condition ◽  
Limb Reconstruction ◽  
Correction Surgery ◽  
First Year Of Life

Purpose To review the initial deformity and subsequent remodelling in posteromedial bowing of the tibia and the outcome of limb reconstruction in this condition. Patients and Methods In all, 38 patients with posteromedial bowing of the tibia presenting between 2000 and 2016 were identified. Mean follow-up from presentation was 78 months. A total of 17 patients underwent lengthening and deformity correction surgery, whilst three further patients are awaiting lengthening and deformity correction procedures. Results The greatest correction of deformity occurred in the first year of life, but after the age of four years, remodelling was limited. The absolute leg-length discrepancy (LLD) increased throughout growth with a mean 14.3% discrepancy in tibial length. In the lengthening group, mean length gained per episode was 45 mm (35 to 60). Mean duration in frame was 192 days, with a mean healing index of 42.4 days/cm. Significantly higher rates of recurrence in LLD were seen in those undergoing lengthening under the age of ten years (p = 0.046). Four contralateral epiphysiodeses were also performed. Conclusion Posteromedial bowing of the tibia improves spontaneously during the first years of life, but in 20/38 (53%) patients, limb reconstruction was indicated for significant residual deformity and/or worsening LLD. For larger discrepancies and persistent deformity, limb reconstruction with a hexapod external fixator should be considered as part of the treatment options. Level of evidence Level IV (Case series)

scholarly journals Crecimiento guiado con placas en 8 para la corrección de deformidades angulares en pacientes esqueléticamente inmaduros. [Eight plate guided growth for angular deformity correction in skeletally immature patients.]

10.15417/448 ◽  
2015 ◽  
Vol 80 (4) ◽  
pp. 254 ◽  
Author(s):  
Diego Tourn ◽  
Victoria Allende ◽  
Julio Javier Masquijo
Keyword(s):  
Deformity Correction ◽  
Angular Deformity ◽  
Skeletally Immature ◽  
Guided Growth

<p><strong>Introducción</strong></p><p><strong></strong><em> </em>La manipulación de la fisis permite la corrección de deformidades <em>ón</em>en pacientes esqueléticamente inmaduros. Recientemente, se ha propuesto el empleo de un nuevo implante (placas en 8) que presentaría algunas ventajas con sus antecesores. El objetivo de este estudio es evaluar los resultados radiográficos y las complicaciones de una serie consecutiva de pacientes tratados con este método.</p><p><strong>Material y Métodos</strong></p><p><strong></strong>Se revisaron retrospectivamente las historias clínicas de todos los pacientes esqueléticamente inmaduros con deformidades angulares que se sometieron a cirugía de realineación de miembros inferiores (Rodilla o tobillo) mediante crecimiento guiado con placas en 8 entre Enero de 2009 y Julio del 2013. Se evaluaron los datos demográficos, evolución radiográfica  y la tasa de complicaciones. Todos los niños fueron intervenidos en la misma institución, por tres ortopedistas infantiles.</p><p><strong>Resultado<em>s</em></strong></p><p>Se evaluaron 27 pacientes (47 fisis), 12 de sexo masculino, 15 sexo femenino. 38 fueron tratados por deformidades en valgo y 9 por varo. De las 47 fisis tratadas, 33 fueron en el fémur distal, 12 en la tibia proximal y 2 en la tibia distal.  La edad promedio en la que se realizó el procedimiento fue de 11.8±1.36 años (rango de edad de 8 años – 14 años). El tiempo promedio entre la colocación y el retiro fue de 10.6±3 meses (rango 7 – 26 meses). Todos los pacientes menos uno, presentaron corrección completa de la deformidad. Se presentaron 6 complicaciones postoperatorias y 2 de ellas requirieron una nueva intervención (1 efecto rebote y 1 migración del implante).</p><p><strong>Conclusión</strong></p><p>La utilización de placas en 8 para la corrección de deformidades angulares en pacientes esqueléticamente inmaduros es un método efectivo con una baja tasa de complicaciones.</p>

Angular Deformity Correction by Asymmetrical Physeal Suppression in Growing Children

2010 ◽  
Vol 30 (6) ◽  
pp. 588-593 ◽  
Author(s):  
Sung Jin Shin ◽  
Tae-Joon Cho ◽  
Moon Seok Park ◽  
Jung Yun Bae ◽  
Won Joon Yoo ◽  
...  
Keyword(s):  
Deformity Correction ◽  
Angular Deformity

scholarly journals Correction of Complex Lower Limb Deformities by the Ilizarov Technique: An Audit of Complications

2000 ◽  
Vol 8 (1) ◽  
pp. 67-71 ◽  
Author(s):  
Jean-Claude Theis ◽  
H Simpson ◽  
J Kenwright
Keyword(s):  
Lower Limb ◽  
Deformity Correction ◽  
Limb Lengthening ◽  
Bone Transport ◽  
Angular Deformity ◽  
Ilizarov Technique ◽  
Leg Lengthening ◽  
Limb Deformities ◽  
Lower Limb Reconstruction ◽  
Tract Infections

This is an audit of complications resulting from correction of complex lower limb deformities by the Ilizarov technique. 33 patients (40 bone segments) were reviewed and divided into 4 groups according to the type of surgery carried out: limb lengthening and/or correction of deformity, bone or joint stabilisation, treatment of nonunion or bone defect, angular and/or rotation correction. Most minor complications were fixator specific. Pin tract infections were almost universal but responded well to oral antibiotics and rarely resulted in osteomyelitis. Major complications were procedure specific and more common in those patients who underwent leg lengthening, treatment for nonunion and bone transport. There was also a high incidence of nerve injury as a result of acute angular deformity correction. Despite the high complication rate the Ilizarov technique remains an effective tool for complex lower limb reconstruction surgery.

scholarly journals A new technique for correction of leg length discrepancies in combination with complex axis deformities of the lower limb using a lengthening nail and a locking plate

2018 ◽  
Vol 12 (5) ◽  
pp. 515-525 ◽  
Author(s):  
C. N. Steiger ◽  
U. Lenze ◽  
A. H. Krieg
Keyword(s):  
Functional Outcome ◽  
Locking Plate ◽  
Limb Length ◽  
New Technique ◽  
Angular Deformity ◽  
External Fixators ◽  
Leg Length ◽  
Level Of Evidence ◽  
A New Technique ◽  
Lengthening Nail

Purpose Intramedullary lengthening nails are an accepted alternative to external fixators but are limited by anatomical preconditions. Therefore, to date the use of external fixators is sometimes inevitable. We report on a new technique for correction of combined limb length discrepancies and complex axis deformities using solely internal devices - a lengthening nail and a locking plate. Methods Between October 2008 and November 2011 five patients (two femora, three tibias) with a mean leg length discrepancy of 36 mm (25 to 50) and a complex angular deformity were treated with a fully implantable motorized lengthening nail (Fitbone) and a locking plate. All patients were evaluated with regards to the pre- and postoperative leg length as well as axis alignment, functional outcome, lengthening indices and complications. Results A successful leg length equalization was achieved in all cases and physiological joint orientation angles in all but one case. The mean distraction index was 1.2 mm/day, the maturation index 24 days/cm and the consolidation index 35 days/cm. The functional outcome was very encouraging in all cases with bilateral free range of movement. In total, two complications were observed, one nonunion and one loss of leg length after an early locking bolt removal in a peripheral hospital. Conclusion The combination of a fully implantable motorized lengthening nail and a locking plate is a valuable alternative option for treating selected cases with limb length discrepancies in combination with a complex deformity of the lower leg. However, the reported technique puts high demands on the preoperative planning, operative technique as well as surgeon’s skills. Level of evidence IV (retrospective series)

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