Temporary epiphyseodesis for limb-length discrepancy. (December 2014)

• Record Type: Journal Article
• Authors: Siedhoff, Markus; Ridderbusch, Karsten; Breyer, Sandra; Stücker, Ralf; Rupprecht, Martin
• Is Part Of: Acta orthopaedica. Volume 85:Number 6(2014)
• Page Start: 626
• Page End: 632
• Publication Date: 2014-12
• Subjects: Orthopedics -- Periodicals; 616.7005
• DOI: 10.3109/17453674.2014.960646
• Languages: English
• ISSNs: 1745-3674

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <bold>Background and purpose —</bold> For the treatment of leg-length discrepancies (LLDs) of between 2 and 5 cm in adolescent patients, several epiphyseodesis options exist and various complications have been reported. We reviewed the 8- to 15-year outcome after temporary epiphyseodesis in patients with LLD.</p> <p> <bold>Patients and methods —</bold> 34 children with LLD of up to 5 cm were included in the study. Mean age at epiphyseodesis was 12.8 (10–16) years. Temporary epiphyseodesis was performed with Blount staples or 8-plates. The LLD was reviewed preoperatively, at the time of implant removal, and at follow-up. Every child had reached skeletal maturity at follow-up. Long-standing anteroposterior radiographs were analyzed with respect to the mechanical axis and remaining LLD at the time of follow-up. Possible complications were noted.</p> <p> <bold>Results —</bold> The mean LLD changed from 2.3 (0.9–4.5) cm to 0.8 (–1.0 to 2.6) cm at follow-up (p < 0.001). 21 patients had a final LLD of < 1 cm, and 10 had LLD of < 0.5 cm. At the time of follow-up, in 32 patients the mechanical axis crossed within Steven's zone 1. No deep infections or neurovascular lesions were seen. 4 implant failures occurred, which were managed by revision.</p> <p> <bold>Interpretation —</bold> Temporary epiphyseodesis is an effective and safe option for the treatment of LLD. The timing of the procedure has to be chosen according to the remaining growth, facilitating a full correction of the LLD. If inaccurate placement of staples is avoided, substantial differences between the mechanical axes of both legs at skeletal maturity are rare.</p> </abstract>