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Insertion of Flexible Neural Probes Using Rigid Stiffeners Attached with Biodissolvable Adhesive

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A technical note on improved instrumentation for Blount staple insertion.

Rolf D Burghardt¹, Anastasios D Kanellopoulos, John E Herzenberg

¹AKK Altonaer Kinderkrankenhaus, Abteilung für Kinderorthopädie, Bleickenallee 38, 22763 Hamburg, Germany.

Journal of Children'S Orthopaedics

|August 2, 2013

Summary

New instrumentation allows for accurate and minimally invasive Blount staple insertion, rivaling the eight-Plate Guided Growth System. This updated technique offers a viable alternative for temporary hemiepiphysiodesis in pediatric orthopedics.

Keywords:

Angular deformity Blount staple Eight-Plate Growth plate Surgical instrumentation Temporary hemiepiphysiodesis

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Area of Science:

Pediatric Orthopedics
Surgical Instrumentation
Guided Growth Techniques

Background:

Temporary hemiepiphysiodesis is increasingly popular, with the eight-Plate Guided Growth System largely replacing traditional Blount staples.
The eight-Plate offers advantages in bone purchase and insertion precision, but Blount staples are less expensive and potentially faster for skeletally immature patients.
The original Blount staple insertion technique and instrumentation are outdated.

Purpose of the Study:

To develop novel instrumentation for Blount staple insertion, aiming for accuracy and minimal invasiveness comparable to the eight-Plate.
To modernize the surgical approach for Blount staple placement in pediatric orthopedic procedures.

Main Methods:

Development of wire/drill guides for all three Blount staple sizes.
Guidewire insertion under image intensifier control, followed by drilling pilot holes with a cannulated step drill.
A new, small staple holder was created to facilitate insertion through a small incision.

Main Results:

A functional prototype of the new instrumentation was successfully developed.
The new instrumentation was utilized in three clinical cases, demonstrating its practical application.
The developed system enables Blount staple insertion with accuracy similar to the eight-Plate.

Conclusions:

The modernized Blount staple inserter and instrumentation allow for accurate insertion through smaller incisions.
This innovation provides a more precise and minimally invasive alternative to traditional Blount staple techniques.
The updated method offers comparable accuracy to the eight-Plate Guided Growth System.