Guided growth for angular correction: a preliminary series using a tension band plate

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Skeletal deformities

Background:

• Corrective osteotomy is the standard for pathological angular limb deformities but involves significant risks and recovery burdens.
• Existing guided growth techniques, like stapling, have limitations including implant failure.
• There is a need for safer and more effective methods for limb deformity correction.

Purpose of the Study:

• To evaluate the efficacy and safety of a novel nonlocking extraperiosteal plate and screw guided growth technique.
• To compare the outcomes of this technique with traditional methods like osteotomy and stapling.
• To assess the potential of guided growth to postpone or prevent corrective osteotomies.

Main Methods:

• A prospective series of 34 patients with 65 deformities (femur/tibia) underwent guided growth with a 2-hole plate and screws.
• The technique utilizes the tension band principle, avoiding physeal compression.
• Follow-up ranged from 14 to 26 months, with assessment of deformity correction and hardware status.

Main Results:

• 32 of 34 patients (63 deformities) achieved neutral alignment within a mean of 11 months.
• Correction rates were approximately 30% faster than with stapling.
• No permanent growth arrests occurred; hardware was removed in all corrected cases.

Conclusions:

• Guided growth with this novel plate and screw technique is a promising alternative to corrective osteotomy.
• The technique effectively corrects limb deformities with a high success rate and minimal complications.
• This approach can significantly reduce the need for more invasive surgical procedures in pediatric orthopedic practice.