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Epiphyseal stapling for angular deformity at the knee.

R C Zuege, T G Kempken, W P Blount

    The Journal of Bone and Joint Surgery. American Volume
    |April 1, 1979
    PubMed
    Summary

    Epiphyseal stapling effectively corrected knee angular deformities in children. While rebound occurred in some cases, the procedure demonstrated an 87% success rate with minimal complications, making it a safe treatment option.

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    Area of Science:

    • Orthopedic surgery
    • Pediatric orthopedics
    • Skeletal deformities

    Background:

    • Angular deformities of the knee, such as genu valgum (knock-knees) and genu varum (bowlegs), are common in growing children.
    • These deformities can impact gait, joint function, and long-term skeletal health.
    • Epiphyseal stapling offers a method for guided growth to correct such deformities during the pediatric growth period.

    Purpose of the Study:

    • To evaluate the long-term efficacy and safety of epiphyseal stapling for correcting angular knee deformities in children.
    • To assess the incidence of rebound phenomenon and other complications associated with the procedure.
    • To determine optimal timing and technique for epiphyseal stapling based on skeletal maturity and deformity type.

    Main Methods:

    • A retrospective review of 56 patients (82 knees) treated with epiphyseal stapling between 1954 and 1973.
    • Patients were followed until skeletal maturity, with data collected on deformity type, surgical technique, and outcomes.
    • Staples were removed after overcorrection or when legs appeared straight; rebound phenomenon was noted and analyzed.

    Main Results:

    • 87% of treated angular knee deformities showed satisfactory or improved outcomes.
    • The rebound phenomenon occurred in 35 of 82 deformities (approx. 43%), necessitating careful monitoring and timing of staple removal.
    • No significant complications were reported, with only 10 staple revisions required for extrusion or shifting.

    Conclusions:

    • Epiphyseal stapling is a safe and effective surgical technique for correcting angular knee deformities in skeletally immature children.
    • Careful patient selection, considering skeletal age and deformity type, is crucial for successful outcomes.
    • While the rebound phenomenon can occur, it does not negate the overall benefits of epiphyseal stapling when indicated.

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