[Percutaneous epiphysiodesis. Analysis of a series of 60 full-grown patients]

Percutaneous epiphysiodesis is the actual treatment for mild leg length discrepancy. The authors discuss complications and efficiency of this technique and its accuracy for the prevision of leg length discrepancy.

We reviewed 60 skeletally mature patients (35 boys, 25 girls). Limb length was defined by clinical and teleradiographic evaluation. Bone age was recorded using Sempé's and Pavia's atlas, using the hand, and Sauvegrain's method, using the elbow. Anticipated discrepancies and timing of epiphysiodesis were calculated using Héchard and Carlioz's graph. The percutaneous curetage was employed in all cases.

The treatment was successful for all cases. Complications occurred postoperatively in 2 children who developed an hematoma. 10 children required a surgical revision: 2 cases had an inverted discrepancy, 4 patients were found to have limb deviation, and in four children this treatment was not adequate. The outcome was excellent in 48.3 per cent of cases, satisfactory in 31.7 per cent, acceptable in 6.7 per cent and bad for 13.3 per cent of cases.

Percutaneous epiphysiodesis is well tolerated in childhood with similar results to other techniques (stapling and Phemister's technique). Our experience suggest that:--complications are rare--this treatment is a satisfactory surgical solution--effective previsions for the best time for surgery have not yet been defined.