Angular deformity correction by asymmetrical physeal suppression in growing children: stapling versus percutaneous...

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Skeletal deformities

Background:

• Angular deformities in growing children require effective correction methods.
• Hemiepiphyseal stapling and transphyseal screw placement are surgical options.
• Comparing the efficacy and outcomes of these techniques is crucial.

Purpose of the Study:

• To compare angular deformity correction outcomes between hemiepiphyseal stapling and percutaneous hemiepiphysiodesis using transphyseal screws.
• To evaluate physeal behavior, correction rates, and postoperative courses for both methods.

Main Methods:

• A comparative study involving 19 patients (43 physes) with stapling and 23 patients (37 physes) with screw placement.
• Follow-up to skeletal maturity or at least 1 year post-hardware removal.
• Assessment of angular correction, physeal behavior, and postoperative recovery.

Main Results:

• Both methods achieved angular correction in most patients.
• No significant difference in correction rates between stapling and screw groups.
• Screw group experienced less pain, shorter hospital stays, and smaller scars; stapling group had complications including staple extrusion and premature physeal arrest.

Conclusions:

• Percutaneous transphyseal screw hemiepiphysiodesis is effective for angular deformity correction, comparable to stapling.
• The screw technique is minimally invasive and showed no permanent physeal arrest in this study.
• Transphyseal screws offer advantages in terms of patient recovery and surgical invasiveness.