The 8-plate versus physeal stapling for temporary hemiepiphyseodesis correcting genu valgum and genu varum: A retrospective analysis of thirty five patients

摘要

Purpose: In skeletally immature patients, treatment of malalignment about the knee is possible by performing temporary hemi-epiphyseodesis. Following the well-established procedure of physeal stapling, the 8-plate was introduced as a new device. The purpose of this study was to compare physeal stapling with 8-plate hemi-epiphyseodesis. We focused on evaluating deformity correction, complication rate and duration of the procedures. Methods: We retrospectively analysed 35 patients (61 extremities, age 2.9-16.0 years) who were treated by temporary hemi-epiphyseodesis about the knee for correction of genu varum or genu valgum by using Blount staples (32 extremities) or the 8-plate (29 extremities). Plain radiographs were analysed at the time of operation and at hardware removal that included measurement of mechanical axis deviation, mechanical lateral distal femoral angle and mechanical medial proximal tibial angle. Time until hardware removal, operation time and complications were recorded. Results: A statistically significant improvement of all radiographic measurements could be achieved with comparable results in both groups. Complications were similar in both groups with no relevant differences in amount and severity. In the 8-plate group, however, the surgical time was significantly shorter by an average of ten minutes for implantation and 12 minutes for explantation. Conclusions: Both Blount stapling and the 8-plate technique are methods for correction of genu varum and valgum deformity in skeletally immature patients; however, a shorter operating time for implantation and explantation was noted for the 8-plate technique.