Percutaneous epiphysiodesis: experimental study and preliminary clinical results

Area of Science:

• Orthopedics
• Pediatric Orthopedics
• Surgical Innovation

Background:

• Premature closure of the distal femoral epiphyseal plate is a surgical goal for correcting leg length discrepancies.
• Percutaneous techniques offer minimally invasive options for orthopedic procedures.

Purpose of the Study:

• To evaluate the feasibility and efficacy of percutaneous drilling and pneumatic burring for premature closure of the distal femoral epiphyseal plate in an immature rabbit model.
• To assess the preliminary outcomes of percutaneous epiphysiodesis in pediatric patients.

Main Methods:

• An experimental study in immature New Zealand white rabbits using percutaneous drilling and pneumatic burring under image intensification.
• Serial roentgenograms and microscopic examination of epiphyseal plates.
• Application of the technique in 13 pediatric patients.

Main Results:

• Eight of nine rabbits demonstrated complete arrest of the operated epiphysis with bone fusion at the distal femoral epiphyseal plate.
• Radiographic evidence of fused growth plates in all 13 pediatric patients post-procedure.
• Leg length discrepancy was documented in the rabbit model.

Conclusions:

• Percutaneous drilling and pneumatic burring is a feasible method for inducing premature closure of the distal femoral epiphyseal plate in rabbits.
• Preliminary results in children suggest successful growth plate fusion, though complete growth arrest requires further long-term evaluation.
• This minimally invasive technique shows potential for correcting leg length discrepancies but requires further documentation and follow-up.