Percutaneous epiphysiodesis using transphyseal screws for limb-length discrepancies: high variability among growth...

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Limb reconstruction

Background:

• Limb-length discrepancy (LLD) is a common orthopedic condition.
• Percutaneous epiphysiodesis using transphyseal screws (PETS) offers a minimally invasive approach.
• PETS allows immediate weight-bearing and potential reversibility.

Purpose of the Study:

• To report outcomes of PETS for LLD correction.
• To evaluate the accuracy of three growth prediction models in forecasting LLD at skeletal maturity.

Main Methods:

• Retrospective analysis of 16 patients (average age 14 years) treated with PETS for LLD.
• Comparison of predicted LLD (using Green-Anderson, Moseley, and Paley methods) with actual LLD at skeletal maturity.
• Assessment of preoperative LLD versus final LLD at skeletal maturity.

Main Results:

• PETS corrected a mean preoperative LLD of 3.1 cm to 1.7 cm at skeletal maturity (p < 0.001).
• Growth prediction models showed variability: Green-Anderson (0.2 cm), Moseley (1.4 cm), and Paley (-0.1 cm) mean error.
• Six patients experienced minor screw-head pain; no infections or deformities occurred.

Conclusions:

• Growth prediction models for LLD have significant variability, with an average error of 1.4 cm.
• PETS effectively improved LLD, but earlier surgical timing may enhance results.
• Further research into optimal timing for PETS in LLD management is warranted.