8dlahy – nové možnosti v managementu řešení osových a délkových diskrepancí dolních končetin u dětí. Naše první zkušenosti

JOCHYMEK, Jiří and Tereza PETERKOVÁ. 8dlahy – nové možnosti v managementu řešení osových a délkových diskrepancí dolních končetin u dětí. Naše první zkušenosti (Eight-Plate Guided Growth Treatment for Angular Deformities and Length Discrepancies of the Lower Limbs in Children. Our First Experience). Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca. Praha: Galén, 2015, vol. 82, No 6, p. 424-429. ISSN 0001-5415.

Basic information

Original name

8dlahy – nové možnosti v managementu řešení osových a délkových diskrepancí dolních končetin u dětí. Naše první zkušenosti

Name (in English)

Eight-Plate Guided Growth Treatment for Angular Deformities and Length Discrepancies of the Lower Limbs in Children. Our First Experience

Authors

JOCHYMEK, Jiří (203 Czech Republic, guarantor, belonging to the institution) and Tereza PETERKOVÁ (203 Czech Republic, belonging to the institution)

Edition

Acta chirurgiae orthopaedicae et traumatologiae Čechoslovaca, Praha, Galén, 2015, 0001-5415

---

Other information

Language

Czech

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 0.552

RIV identification code

RIV/00216224:14110/15:00085235

Organization unit

Faculty of Medicine

UT WoS

000367420600006

Keywords in English

angular deformity; leg length discrepancy; children; adolescents; genu valgum; eight-plate

Tags

EL OK

Tags

International impact, Reviewed

---

Abstract

V originále

8dlahy – nové možnosti v managementu řešení osových a délkových diskrepancí dolních končetin u dětí. Naše první zkušenosti.

In English

PURPOSE OF THE STUDY The aim of this paper is to present our first experience with and the results of treating angular deformities and length discre pancies of the lower limbs in children and adolescents using the eight-plate system, and to compare our results with the literature data. MATERIAL AND METHODS A total of 22 patients underwent surgery for the correction of angular deformities or length discrepancies of the lower limbs in 2014. Using eight-plates, temporary medial hemiepiphysiodesis was carried out in 13 patients with the diagnosis of genu valgum (group 1). In nine patients (group 2) the eight-plate was used to correct milder forms of leg length discrepancy by epiphysiodesis involving the distal femur only or also the proximal tibia. The eight-plate system consists of a plate with two or more holes and two screws. Under X-ray image intensifier guidance, the plate was inserted above the physis of the long bone through a minimally invasive approach. Pre-operative long-standing radiographs of the lower extremities were measured. Post-operatively, radiographic assessments and clinical examinations were done at 3-month intervals to monitor the effects of therapy. RESULTS In group 1, the average pre-operative intermalleolar distance (IMD) measured on standing radiographs was 15.2 cm. The average lateral distal femoral angle (LDFA) of 82° before surgery increased to 90° and the average pre-operative medial proximal tibial angle (MPTA) of 95° decreased to 88° at the time of plate removal. In all group 1 patients the therapy was completed successfully at an average of 9.2 months. The mean values of changes recorded at 3-month intervals of followup were 2.1° (± 0.9°) for LDFA and 1.5° (± 0.6°) for MPTA. The therapy in group 2 (average leg length inequality, 2.1 cm) was finished and evaluated in seven patients; in two patients it remained to be completed. The average eight-plate guided growth treatment was 12.7 months, and the average reduction in leg-length discrepancy recorded at 3-month intervals was 4.9 mm. There were no complications. DISCUSSION All our results so far obtained are in agreement with those of the authors pursuing this topic for a longer time. Compared to the currently used Blount’s staples, the eight-plate treatment has an advantage in being growth plate-friendly; it avoids damaging the growing physis and is thus suitable for use in children under 10 years of age. It is also associated with a fewer number of complications. CONCLUSIONS Our first results, although based on a short follow-up, clearly show that the eight-plate guided growth method has several advantages; it is a great contribution to surgery and brings new options particularly for the correction of angular deformities in patients under 10 years.