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Comparative Study
Hemiepiphysiodesis for Idiopathic Genu Valgum: Percutaneous Transphyseal Screw Versus Tension-band Plate.
- Hoon Park, Minjung Park, Sung Min Kim, Hyun Woo Kim, and Dong Hoon Lee.
- Department of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu.
- J Pediatr Orthop. 2018 Jul 1; 38 (6): 325-330.
BackgroundThe aim of this study was to compare the outcomes of angular deformity correction by percutaneous hemiepiphysiodesis using transphyseal screw (PETS) or tension-band plating (TBP) in growing children with idiopathic genu valgum with emphasis on the rate of deformity correction.MethodsWe retrospectively reviewed cases of hemiepiphysiodesis for angular deformity in lower extremities between 2009 and 2014. A total of 90 limbs in 33 patients received PETS and 60 limbs in 24 patients received TBP. Angular measurements were compared preoperatively and at the time of hardware removal. The amount and rate of angular deformity correction were compared between the 2 groups. Potential factors affecting correction velocity were investigated using multivariate analysis.ResultsAngular correction was achieved in all patients. The mean rate of correction was more rapid with PETS than with TBP at both the distal femur (0.92 vs. 0.64 deg./mo, respectively; P<0.001) and proximal tibia (0.72 vs. 0.55 deg./mo, respectively; P=0.019). Multivariate analysis showed that the used implant significantly affected the rate of correction: PETS demonstrated faster correction velocity than TBP (-0.26, 95% confidence interval, -0.35 to -0.17, P<0.001).ConclusionsBoth PETS and TBP techniques result in satisfactory correction of coronal angular deformity in patients with idiopathic genu valgum. However, the observed rate of correction was faster with PETS than TBP. Correction with PETS, rather than TBP, may better serve patients near skeletal maturity.Level Of EvidenceLevel III-retrospective comparative series.
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