Temporary epiphyseodesis for limb-length discrepancy. 8- to 15-year follow-up of 34 children
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Temporary epiphyseodesis for limb-length discrepancy. 8- to 15-year follow-up of 34 children. / Siedhoff, Markus; Ridderbusch, Karsten; Breyer, Sandra; Stücker, Ralf; Rupprecht, Martin.
In: ACTA ORTHOP, Vol. 85, No. 6, 01.12.2014, p. 626-632.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Temporary epiphyseodesis for limb-length discrepancy. 8- to 15-year follow-up of 34 children
AU - Siedhoff, Markus
AU - Ridderbusch, Karsten
AU - Breyer, Sandra
AU - Stücker, Ralf
AU - Rupprecht, Martin
N1 - Zuordnung UKE-Affiliation unklar (Siedhoff, Ridderbusch, Rupprecht). Alles andere ok.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - BACKGROUND AND PURPOSE: 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.PATIENTS AND METHODS: 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.RESULTS: 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.INTERPRETATION: 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.
AB - BACKGROUND AND PURPOSE: 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.PATIENTS AND METHODS: 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.RESULTS: 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.INTERPRETATION: 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.
KW - Adolescent
KW - Arthrodesis
KW - Bone Lengthening
KW - Child
KW - Device Removal
KW - Epiphyses
KW - Female
KW - Femur
KW - Follow-Up Studies
KW - Humans
KW - Leg Length Inequality
KW - Male
KW - Prosthesis Failure
KW - Sutures
KW - Tibia
KW - Treatment Outcome
U2 - 10.3109/17453674.2014.960646
DO - 10.3109/17453674.2014.960646
M3 - SCORING: Journal article
C2 - 25191935
VL - 85
SP - 626
EP - 632
JO - ACTA ORTHOP
JF - ACTA ORTHOP
SN - 1745-3674
IS - 6
ER -