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Angular deformities after percutaneous epiphysiodesis for leg length discrepancy.

Hannah Weinmayer1, Anne B Breen2, Harald Steen3

  • 1University of Oslo, Oslo, Norway.

Journal of Children'S Orthopaedics
|October 14, 2022
PubMed
Summary

Secondary angular deformities are common after percutaneous epiphysiodesis. The severity of these deformities in limb length discrepancy surgery correlates with remaining growth potential at the time of the procedure.

Keywords:
Percutaneous epiphysiodesisangular deformitycomplicationleg length discrepancylimb alignment

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Area of Science:

  • Orthopedic surgery
  • Pediatric orthopedics
  • Limb reconstruction

Background:

  • Percutaneous epiphysiodesis is a surgical technique used to correct limb length discrepancies.
  • Understanding potential complications like secondary angular deformities is crucial for patient outcomes.

Purpose of the Study:

  • To systematically analyze secondary angular deformities following percutaneous epiphysiodesis.
  • To determine if deformity occurrence and magnitude correlate with remaining growth potential at surgery.

Main Methods:

  • Retrospective analysis of 140 percutaneous epiphysiodesis procedures in 88 patients (2002-2020).
  • Radiographic measurements of mechanical axis and joint orientation angles on long-standing radiographs.
  • Assessment of remaining growth using the Menelaus method.

Main Results:

  • A significant correlation was found between secondary frontal plane deformities and remaining growth at surgery (p=0.003).
  • Nine percent of patients showed a mechanical axis change of ≥10 mm.
  • The magnitude of angular deformities was linked to the amount of growth remaining.

Conclusions:

  • Percutaneous epiphysiodesis can lead to a high rate of secondary angular deformities.
  • Surgical technique modifications, such as central growth plate ablation, may be considered.
  • Systematic follow-up is essential for early detection of post-operative deformities.