Abstract
Purpose: This study aimed to compare the efficacy of decreasing leg-length discrepancy (LLD) and postoperative complications between tension band plates (TBP) and percutaneous transphyseal screws (PETS). Methods: This retrospective study reviewed LLD patients who underwent temporary epiphysiodesis at the distal femur and/ or proximal tibia from 2010 to 2017 (minimum two years fol-low-up). Efficacy of decreasing LLD was assessed one and two years postoperatively. Complications were classified with the modified Clavien-Dindo-Sink complication classification system. Knee deformities were assessed by percentile and zone of mechanical axis across the tibial plateau. Results: In total, 53 patients (25 boys, 28 girls) underwent temporary epiphysiodesis (mean age, 11.4 years). The efficacy of decreasing LLD at two years between the TBP (n = 38) and PETS (n = 15) groups was comparable. Seven grade III complications were recorded in six TBP patients and in one PETS patient who underwent revision surgeries for knee deformities and physis impingement. Four grade I and two grade II complications occurred in the TBP group. The mechanical axis of the leg shifted laterally in the PETS group and medially in the TBP groups (+7.1 percentile versus-4.2 percentile; p < 0.05). Shifting of the mechanical axis by two zones was noted medially in four TBP patients and laterally in two PETS patients. Conclusion: More implant-related complications and revision surgeries for angular deformities were associated with TBP. A tendency of varus and valgus deformity after epiphysiodesis using TBP and PETS was observed, respectively. Patients and families should be informed of the risks and regular postoperative follow-up is recommended.
Original language | English |
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Pages (from-to) | 106-113 |
Number of pages | 8 |
Journal | Journal of Children's Orthopaedics |
Volume | 15 |
Issue number | 2 |
DOIs | |
State | Published - 2021 |
Bibliographical note
Publisher Copyright:© 2021, British Editorial Society of Bone and Joint Surgery. All rights reserved.
Keywords
- Complication
- Epiphysiodesis
- Knee deformity
- Leg-length discrepancy
- Tension band plate
- Transphyseal screw