Comparison of Eight-Plate With Reconstruction-Plate in Temporary Hemiepiphysiodesis to Correct the Idiopathic Genu Valgum in Pediatrics Publisher



Ghaznavi A¹ ; Baghdadi T² ; Bagherifard A¹ ; Fakoor S¹ ; Shirvani S¹ ; Kiaei SMS¹ ; Mohammadpour M¹ Show Affiliations
Source: Archives of Bone and Joint Surgery Published:2022

Abstract

Background: High cost of eight-plate makes it unavailable in many countries; therefore, developing an alternative device for temporary hemiepiphysiodesis of knee deformities in pediatrics is valuable. In this study, we compared the outcome of the eight-plate with the reconstruction-plate in this setting. Methods: In this retrospective study, 109 skeletally immature patients (212 physes) who underwent temporary hemiepiphysiodesis to correct idiopathic genu valgum were included. The eight-plate and reconstruction-plate were used in 47 patients (90 physes) and 62 patients (122 physes), respectively. Outcome measures were the valgus angle, medial proximal tibial angle (MPTA), the lateral distal femoral angle (LDFA), the joint-line convergence angle (JLCA), and lower limb mechanical axis (LLMA). Results: The baseline characteristics of the patients were comparable between the two plate groups. The mean follow-up of the patients was 32.9 ± 15.1 months. The mean MPTA change was 2.7 ± 3.7ºin the eight-plate group and 2.1 ± 3.4ºin the reconstruction-plate group (P=0.2). The mean LDFA improvement was 8 ± 3.7ºin the eight-plate group and 7.9 ± 3.5ºin the reconstruction-plate group (P=0.61). The mean valgus correction was 10.7 ± 4.4ºin the eight-plate group and 10.4 ± 4.6ºin the reconstruction-plate group (P=0.74). Moreover, the mean change of JLCA was 0.7 ± 1.3ºin the eight-plate group and 0.8 ± 1.3ºin the reconstruction-plate group (P=0.58). The postoperative LLMA was comparable between the two study groups as well. In total, five postoperative complications were recorded in this series, which included one case of screw loosening in each group, two cases of overcorrection, and one screw breakage in the reconstruction-plate group. Conclusion: The radiologic results and complications of the reconstruction-plate are comparable with the eight-plate. Therefore, it can be safely and efficiently used in hemiepiphysiodesis to correct idiopathic genu valgum. COPYRIGHT 2022 © BY THE ARCHIVES OF BONE AND JOINT SURGERY.