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Related Concept Videos

Temperature Dependent Deformation01:12

Temperature Dependent Deformation

In a nonhomogeneous rod made up of steel and brass, restrained at both ends and subjected to a temperature change, several steps are involved in calculating the stress and compressive load. Due to the problem's static indeterminacy, one end support is disconnected, allowing the rod to experience the temperature change freely. Next, an unknown force is applied at the free end, triggering deformations in the rod's steel and brass portions. These deformations are then calculated and added together...
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Tension-band Plating for Leg-length Discrepancy Correction.

Jaap J Tolk1, Rajiv Merchant2, Peter R Calder3

  • 1Department of Orthopaedics and Sports Medicine, Erasmus MC-Sophia Children's Hospital, Rotterdam, South Holland, Netherlands; Catterall Unit, Royal National Orthopaedic Hospital, Stanmore, United Kingdom.

Strategies in Trauma and Limb Reconstruction
|June 23, 2022
PubMed
Summary

Dual tension-band plates effectively correct leg-length discrepancy (LLD). While generally safe, tibial correction may alter intra-articular angles, suggesting careful patient selection for this guided growth technique.

Keywords:
EpiphysiodesisGuided growthLeg-length discrepancyTension-band plating

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Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Skeletal growth modulation

Background:

  • Dual tension-band plates are utilized for temporary epiphysiodesis and longitudinal guided growth.
  • Accurate leg-length equalization is crucial for optimal musculoskeletal development and function.

Purpose of the Study:

  • To evaluate the rate of correction achieved with dual tension-band plates.
  • To identify any intra-articular deformities in the femur and tibia during correction.
  • To document the resumption of skeletal growth following plate removal.

Main Methods:

  • Retrospective analysis of 34 patients treated with dual tension-band plates (2012-2020).
  • Radiographic measurements included leg-length discrepancy (LLD), joint line congruency angle (JLCA), tibial roof angle, femoral floor angle, and notch-intercondylar distance.
  • Measurements were taken pre-operatively, post-correction, and at skeletal maturity.

Main Results:

  • Mean LLD reduction was 12.9 mm, with a residual mean difference of 8.4 mm.
  • Correction rates were 0.40 mm/month (proximal tibia) and 0.68 mm/month (distal femur).
  • A significant change in tibial roof angle (8.4°) was noted post-correction; no significant intra-articular changes occurred in the distal femur.

Conclusions:

  • Dual tension-band plating significantly reduces LLD.
  • Intra-articular changes were observed only in the proximal tibia, not the distal femur.
  • This technique is valuable for leg-length equalization, particularly in younger patients or when growth is unpredictable.