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Phemister epiphysiodesis in leg length inequality treatment--evaluative outcome analysis
Paweł Koczewski1, Anna Fryzowicz1
1Department of Pediatric Orthopedics and Traumatology, Karol Marcinkowski University of Medical Sciences of Poznan.
Background:
The aim of this study was to evaluate the efficacy of Phemister epiphysiodesis for leg length inequality (LLI) treatment in comparison with epiphysiodesis techniques currently in use and to determine factors that may influence outcomes.
Materials And Methods:
Nineteen girls and sixteen boys with a mean skeletal age of 12.2 years and a mean functional LLI of 3.8 cm at the time of surgery were enrolled. Data were retrieved from hospital records and bone ages were determined using standard atlases. Mean follow-up duration was 7 years.
Results:
Good results (final LLI < 1.5 cm) were obtained in 74.3% of patients, fair results (final LLI 1.6-2.0 cm.) were seen in 5.7% and poor results (final LLI > 2 cm) were seen in 20%. A mean clinical LLI of 1.7 cm was the treatment outcome for the entire group. Valgus deformity of 7°, 10° and 13° occurred in three patients.
Conclusions:
1. Phemister epiphysiodesis performed for LLI produced the desired correction but was associated with a risk of over- or undercorrection and frontal plane deformity due to inadequate physeal closure. 2. These complications are typical for any kind of epiphysiodesis.
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