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Greater trochanteric epiphysiodesis.

James J McCarthy1, Dennis S Weiner

  • 1Shriners Hospitals for Children, 3551 North Broad Street, Philadelphia, PA 19140, USA. jmccarthy@shrinenet.org

International Orthopaedics
|March 14, 2007
PubMed
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Greater trochanteric epiphysiodesis (GTE) effectively slows hip growth in children with Perthes disease. Bone peg GTE and older age groups showed greater growth inhibition, suggesting optimized surgical timing and technique can improve outcomes.

Area of Science:

  • Orthopedic Surgery
  • Pediatric Orthopedics
  • Growth Plate Surgery

Background:

  • Perthes disease can affect hip development and lead to long-term complications.
  • Greater trochanteric overgrowth is a potential consequence of Perthes disease.
  • Surgical intervention, such as greater trochanteric epiphysiodesis (GTE), aims to normalize hip morphology.

Purpose of the Study:

  • To evaluate the efficacy of GTE in slowing greater trochanteric growth.
  • To compare the effectiveness of bone peg versus screw epiphysiodesis.
  • To determine the optimal age for GTE in children with Perthes disease.

Main Methods:

  • Retrospective study of 35 children with unilateral Perthes disease undergoing GTE.
  • Radiographic measurement of greater trochanter height pre- and post-surgery (minimum 2-year follow-up).

Related Experiment Videos

  • Comparison with the unaffected contralateral hip as a control; epiphysiodesis performed using drill holes with bone peg or screw.

    • Main Results:

    • GTE inhibited greater trochanter growth by 0.9 mm/year compared to the unaffected side (p=0.007).
    • Bone peg epiphysiodesis resulted in greater growth inhibition (1.8 mm/year).
    • Children over 8 years old exhibited greater growth inhibition following GTE.

    Conclusions:

    • GTE is an effective method for inhibiting greater trochanter growth in children with Perthes disease.
    • Bone peg epiphysiodesis appears more effective than screw epiphysiodesis.
    • Older children (>8 years) may benefit more from GTE, contrary to initial expectations.