[Growth modulation through hemiepiphysiodesis : Novel surgical techniques: risks and progress].
Kniegelenksnahe Wachstumsmodulation durch Hemiepiphysiodese : Neue Operationstechniken: Fortschritte und Risiken.
Adolescent
Children
Epiphysiodesis
Genu valgum
Genu varum
Growth modulation
Growth plate
Lower extremity deformities
Journal
Der Orthopade
ISSN: 1433-0431
Titre abrégé: Orthopade
Pays: Germany
ID NLM: 0331266
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
accepted:
10
05
2021
pubmed:
26
6
2021
medline:
2
7
2021
entrez:
25
6
2021
Statut:
ppublish
Résumé
The correction of angular deformities of the lower limb is a key task in paediatric orthopaedic surgery. The growth potential of the physis can be employed for the correction of these malalignments in childhood and adolescence. Hemiepiphysiodesis (HED) is a surgical technique used for growth modulation by permanent or temporary asymmetrical arrest of the growth plate. In permanent HED, exact timing of the procedure is mandatory to achieve optimal correction. Temporary HED through tension band devices such as two-hole-plates or flexible staples has been established as the treatment of choice for growth guidance with excellent results. Implant-associated complications have been significantly reduced through implant modifications. Several experimental procedures have the potential to achieve growth modulation even without the requirement of surgical intervention. Die Korrektur von Achsfehlstellungen der unteren Extremität in der Frontalebene zählt zu den wesentlichen Aufgaben der Kinderorthopädie. Im Kindes- und Jugendalter kann das Wachstumspotenzial der Epiphysenfugen zum operativen Ausgleich dieser Beinachsendeformitäten genutzt werden. Die Wachstumsmodulation mittels Hemiepiphysiodese (HED) wird durch eine permanente oder temporäre asymmetrische Blockierung der Epiphysenfuge erreicht. Bei der permanenten HED erfolgt eine irreversible Destruktion der Wachstumsfuge, weshalb eine exakte Bestimmung des Interventionszeitpunktes unabdingbar ist. Die temporäre HED mittels Tension-Band-Implantaten wie 2‑Loch-Platten und flexiblen Klammern hat sich mittlerweile mit ausgezeichneten Ergebnissen als Standardmethode zur Wachstumslenkung etabliert. Implantatassoziierte Komplikationen konnten durch stetige Modifikation der Implantate bedeutend reduziert werden. Verschiedene experimentelle Verfahren besitzen das Potenzial zur Durchführung einer Wachstumsmodulation, möglicherweise sogar ohne die Notwendigkeit einer chirurgischen Intervention.
Autres résumés
Type: Publisher
(ger)
Die Korrektur von Achsfehlstellungen der unteren Extremität in der Frontalebene zählt zu den wesentlichen Aufgaben der Kinderorthopädie. Im Kindes- und Jugendalter kann das Wachstumspotenzial der Epiphysenfugen zum operativen Ausgleich dieser Beinachsendeformitäten genutzt werden. Die Wachstumsmodulation mittels Hemiepiphysiodese (HED) wird durch eine permanente oder temporäre asymmetrische Blockierung der Epiphysenfuge erreicht. Bei der permanenten HED erfolgt eine irreversible Destruktion der Wachstumsfuge, weshalb eine exakte Bestimmung des Interventionszeitpunktes unabdingbar ist. Die temporäre HED mittels Tension-Band-Implantaten wie 2‑Loch-Platten und flexiblen Klammern hat sich mittlerweile mit ausgezeichneten Ergebnissen als Standardmethode zur Wachstumslenkung etabliert. Implantatassoziierte Komplikationen konnten durch stetige Modifikation der Implantate bedeutend reduziert werden. Verschiedene experimentelle Verfahren besitzen das Potenzial zur Durchführung einer Wachstumsmodulation, möglicherweise sogar ohne die Notwendigkeit einer chirurgischen Intervention.
Identifiants
pubmed: 34170353
doi: 10.1007/s00132-021-04122-8
pii: 10.1007/s00132-021-04122-8
doi:
Types de publication
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
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