Deformity correction during growth after partial physeal arrest

The purpose of this study was to evaluate our treatment protocol for certain physeal injuries requiring complete epiphysiodesis of an injured physis, angular correction and lengthening with the Ilizarov method and overcorrection of length according to calculated loss of remaining growth. Five patients (age: 12 to 14 years) were operated with angular correction and lengthening in combination with complete epiphysiodesis. Angular deformities measured 12 degrees to 24 degrees and limb length discrepancies (LLD's) 15 to 60 mm. Mean overcorrection of length according to remaining growth of the affected physis was 12 mm (range: 7 to 15). All deformity parameters were fully corrected in all patients. Mechanical axis deviation (MAD) was within +/- 5 mm compared to the healthy side in 4 patients, 20 mm in one patient. Median LLD at maturity was 8 mm (range: 3 to 13). In cases of partial physeal arrest with severe symptomatic deformities, complete epiphysiodesis of the injured physis, angular correction and lengthening with the Ilizarov method with overcorrection of length according to estimated loss of remaining growth of the affected physis is a suitable method.