The effectiveness of physeal bar resection with or without Hemi-Epiphysiodesis to treat partial growth arrest

BMC Musculoskeletal Disorders

Research

Qian Tan¹  Haibo Mei¹  Han Xiao¹  Jiangyan Wu¹  Guanghui Zhu¹  An Yan¹  Weihua Ye¹  Miao Li¹ 

[1] Department of Pediatric Orthopaedics, Hunan Children’s Hospital, No 86 Ziyuan Road, Yuhua District, 410007, Changsha City, Hunan Province, China;The Pediatric Academy of University of South China, 410007, Changsha, Hunan, China;

关键词: Partial physeal growth arrest;    Physeal bar resection;    Hemi-Epiphysiodesis technique;    Angular deformity;    LLD;   

DOI  :  10.1186/s12891-023-06167-6

 received in 2022-07-10, accepted in 2023-01-16,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeTo evaluate the outcomes of distal femoral, proximal tibial, and distal tibial physeal bar resection combined with or without the Hemi-Epiphysiodesis procedure and provide a better understanding of the application of physeal bar resection combined with Hemi-Epiphysiodesis procedure in the treatment of physeal bar growth arrest.MethodsWe retrospectively reviewed the patients who suffered physeal bar and underwent physeal bar resection with or without the Hemi-Epiphysiodesis technique during 2010–2020. All were followed up for at least 2 years or to maturity. A modified mapping method was used to determine the area of a physeal bar by CT data. The aLDFA, aMPTA, aLDTA, MAD, and LLD were measured to assess the deformity of the lower limb.ResultsIn total, 19 patients were included in this study. The average age was 8.9 years (range 4.4 to 13.3 years old). During the follow-up, 4 (21.1%) patients had an angular change < 5°; 12 (63.2%) patients had angular deformity improvement > 5° averaging 10.0° (range 5.3° to 23.2°), and 3 (15.8%) patients had improvement of the angular deformity averaging 16.8° (range 7.4° to 27.1°). Eleven patients (57.9%) had significant MAD improvement. After surgery, we found that 7 (36.8%) patients had an LLD change of < 5 mm and were considered unchanged. Only 2 (15%) patients had an LLD improvement > 5 mm averaging 1.0 cm (range 0.7 to 1.3 cm), and 7 (36.8%) patients had increasing of LLD > 5 mm averaging 1.3 cm (range 0.5 to 2.5 cm). There were no postoperative fractures, infections, or intraoperative complications such as neurovascular injury.ConclusionPhyseal bar resection combined with Hemi-epiphysiodesis is helpful for partial epiphysis growth arrest. Without statistically verifying, we still believe that patients with limited growth ability could benefit more from physeal bar resection combined with Hemi-epiphysiodesis.

【 授权许可】

CC BY   
© The Author(s) 2023

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