Smartphone Monitoring of Guided Growth

Hemiepiphysiodesis-also called guided growth-procedures have become one of the most common pediatric orthopaedic treatments for limb deformity. Using the patient's own growth to gradually correct limb alignment minimizes complications and postoperative restrictions compared to acute correction methods including osteotomies. However, this approach requires ongoing, regular follow-up exams and imaging to monitor progress and prevent complications, typically until skeletal maturity. This follow-up can be burdensome and costly for patients, parents, the environment, and health care systems.Current follow-up protocols often require multiple missed days of work and school for the patient and their family members or support individuals who assist with transportation and childcare. As a result, certain populations including those patients living in remote or low-resource areas are more vulnerable to being lost to follow-up. As technology continues to become a leading partner in medicine, employing telehealth as a primary or supplementary mode for monitoring guided growth patients offers an opportunity to reduce these burdens. Here, we present a review of existing evidence related to monitoring challenges and technologies, and we propose a new virtual monitoring protocol for patients undergoing guided growth.

(1)Guided growth of the lower extremity is a common procedure with low complication rates, though it carries risks of overcorrection and rebound deformity.(2)Consistent, appropriate follow-up is crucial for successful treatment.(3)Current follow-up protocols pose challenges for vulnerable patients and their families, affecting health access and equity. They also contribute to environmental burdens, financial costs, and cumulative radiation exposure for involved children.(4)A virtual monitoring protocol for guided growth patients might produce similar results when effectively implemented and could benefit from further refinement and research.