Comparing Percutaneous Physeal Epiphysiodesis and Eight-Plate Epiphysiodesis for the Treatment of Limb Length Discrepancy

• Published in: Journal of pediatric orthopaedics Vol. 37; no. 5; pp. 323 - 327
• Main Authors: Bayhan, Ilhan A, Karatas, Ali F, Rogers, Kenneth J, Bowen, J Richard, Thacker, Mihir M
• Format: Journal Article
• Language: English
• Published: United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-07-2017
• Subjects: Adolescent; Arthrodesis - methods; Bone Lengthening - methods; Bone Plates; Child; Female; Femur - surgery; Growth Plate - surgery; Humans; Leg Length Inequality - diagnostic imaging; Leg Length Inequality - surgery; Male; Radiography; Tibia - surgery
• ISSN: 0271-6798; 1539-2570
• DOI: 10.1097/BPO.0000000000000647

BACKGROUND:Either percutaneous or eight-plate epiphysiodesis have been shown to be effective growth modulation techniques for the treatment of limb length discrepancies (LLD). However, few studies compared the outcomes of both techniques with some confounding results. The aim of this study was to evaluate the outcomes of the both techniques in the treatment of the LLD.
METHODS:Between 2004 and 2012, medical records of all cases that underwent either eight-plate or percutaneous epiphysiodesis (PE) were reviewed. Age at surgery, sex, diagnosis, surgical site (proximal tibia/distal femur), time of follow-up, complications, and additional procedures were noted. Correction of the LLD was evaluated to calculate the rate of correction and the percentage of improvement from the long-leg standing x-rays or scanograms, collected at each visit.
RESULTS:There were 24 patients in the eight-plate (10 girls and 14 boys) and 48 patients in the PE group (28 girls and 20 boys). No statistically significant difference was found in the age, sex, preoperative LLD, or follow-up between groups. Both groups reached to an average LLD below 2 cm. The percentage of improvement was significantly higher in the PE group (P=0.031). The rate of individual femoral and tibial correction did not differ between the groups.
CONCLUSIONS:Both methods are shown to be effective for LLD correction. However, PE led to greater improvement during the same follow-up time with fewer complications and less need for additional surgical procedures.