Tension band plates have greater risks of complications in temporary epiphysiodesis

You Hung Cheng, Wei Chun Lee, Yi Feng Tsai, Hsuan Kai Kao, Wen E. Yang, Chia Hsieh Chang*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

5 Scopus citations

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 languageEnglish
Pages (from-to)106-113
Number of pages8
JournalJournal of Children's Orthopaedics
Volume15
Issue number2
DOIs
StatePublished - 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

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