Percutaneous Epiphysiodesis Using Transphyseal Screws: a Case Series Demonstrating High Efficacy

Area of Science:

• Orthopedic surgery
• Pediatric orthopedics
• Growth plate management

Background:

• Percutaneous epiphysiodesis using transphyseal screws (PETS) is linked to complications like implant failure and angular deformities.
• Previous studies report varied success rates and potential for growth inhibition.

Purpose of the Study:

• To evaluate the complication rate and efficacy of PETS.
• To identify factors influencing the success of PETS in correcting limb length discrepancy.

Main Methods:

• Retrospective analysis of patients undergoing distal femoral and/or proximal tibial PETS (2007-2014).
• Calculation of complications, efficacy (actual vs. expected growth inhibition), and final limb-length discrepancy (LLD).
• Assessment of screw insertion angle, BMI, and thread crossing the physis as factors affecting efficacy.

Main Results:

• 126 physes in 82 patients were treated; mean pre-operative LLD was 27.7 mm.
• Overall complication rate was low: 3.7% required revision epiphysiodesis.
• Mean efficacy was 103% overall; higher BMI and more screw threads across the physis correlated with increased efficacy.

Conclusions:

• PETS efficacy may be better than previously reported, with a low rate of serious complications.
• Ensuring sufficient screw threads across the physis is crucial for optimizing PETS outcomes.
• Higher BMI is associated with improved efficacy in PETS procedures.