Growth arrest: leg length correction through temporary epiphysiodesis with a novel rigid staple (RigidTack).


Journal

The bone & joint journal
ISSN: 2049-4408
Titre abrégé: Bone Joint J
Pays: England
ID NLM: 101599229

Informations de publication

Date de publication:
Aug 2021
Historique:
entrez: 2 8 2021
pubmed: 3 8 2021
medline: 13 8 2021
Statut: ppublish

Résumé

Temporary epiphysiodesis (ED) is commonly applied in children and adolescents to treat leg length discrepancies (LLDs) and tall stature. Traditional Blount staples or modern two-hole plates are used in clinical practice. However, they require accurate planning, precise surgical techniques, and attentive follow-up to achieve the desired outcome without complications. This study reports the results of ED using a novel rigid staple (RigidTack) incorporating safety, as well as technical and procedural success according to the idea, development, evaluation, assessment, long-term (IDEAL) study framework. A cohort of 56 patients, including 45 unilateral EDs for LLD and 11 bilateral EDs for tall stature, were prospectively analyzed. ED was performed with 222 rigid staples with a mean follow-up of 24.4 months (8 to 49). Patients with a predicted LLD of ≥ 2 cm at skeletal maturity were included. Mean age at surgery was 12.1 years (8 to 14). Correction and complication rates including implant-associated problems, and secondary deformities as well as perioperative parameters, were recorded (IDEAL stage 2a). These results were compared to historical cohorts treated for correction of LLD with two-hole plates or Blount staples. The mean LLD was reduced from 25.2 mm (15 to 45) before surgery to 9.3 mm (6 to 25) at skeletal maturity. Implant-associated complications occurred in 4/56 treatments (7%), and secondary frontal plane deformities were detected in 5/45 legs (11%) of the LLD cohort. Including tall stature patients, the rate increased to 12/67 legs (18%). Sagittal plane deformities were observed during 1/45 LLD treatments (2%). Compared to two-hole plates and Blount staples, similar correction rates were observed in all devices. Lower rates of frontal and sagittal plane deformities were observed using rigid staples. Treatment of LLD using novel rigid staples appears a feasible and promising strategy. Secondary frontal and sagittal plane deformities remain a potential complication, although the rate seems to be lower in patients treated with rigid staples. Further comparative studies are needed to investigate this issue. Cite this article:

Identifiants

pubmed: 34334047
doi: 10.1302/0301-620X.103B8.BJJ-2020-1035.R4
pmc: PMC9948429
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1428-1437

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Auteurs

Bjoern Vogt (B)

Children's Orthopaedics, Deformity Correction and Foot Surgery, University Hospital of Muenster, Muenster, Germany.

Robert Roedl (R)

Children's Orthopaedics, Deformity Correction and Foot Surgery, University Hospital of Muenster, Muenster, Germany.

Georg Gosheger (G)

General Orthopaedics and Tumour Orthopaedics, University Hospital of Muenster, Muenster, Germany.

Adrien Frommer (A)

Children's Orthopaedics, Deformity Correction and Foot Surgery, University Hospital of Muenster, Muenster, Germany.

Andrea Laufer (A)

Children's Orthopaedics, Deformity Correction and Foot Surgery, University Hospital of Muenster, Muenster, Germany.

Marie-Theres Kleine-Koenig (MT)

Children's Orthopaedics, Deformity Correction and Foot Surgery, University Hospital of Muenster, Muenster, Germany.

Christoph Theil (C)

General Orthopaedics and Tumour Orthopaedics, University Hospital of Muenster, Muenster, Germany.

Gregor Toporowski (G)

Children's Orthopaedics, Deformity Correction and Foot Surgery, University Hospital of Muenster, Muenster, Germany.

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