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TREATMENT OF GENU VALGUM IN CHILDREN METHOD OF TEMPORARY HEMIEPIPHYSIODESIS USING EIGHTPLATES: SHORT-TERM OUTCOME
Faculty
Medicine
Year:
2020
Type of Publication:
ZU Hosted
Pages:
10
Authors:
Emad Alsayed Mohamed Abdelhady
Staff Zu Site
Abstract In Staff Site
Journal:
American Research Journal of Orthopedics and Traumatology American Research Journal of Orthopedics and Traumatology
Volume:
Keywords :
TREATMENT , GENU VALGUM , CHILDREN METHOD OF TEMPORARY
Abstract:
Background: Angular deformities of the lower extremities cause activity-related pain, altered gait mechanics, and joint instability, and these are exacerbated by periods of growth. Conservative usually fails to correct deformity; correction of deformity by hemiepiphysiodesis has become the standard surgical technique of treatment. Objective: The aim of this study to evaluate temporary hemiepiphysiodesis around the knee to modulate growth with eight-Plate technique in patient with genu valgum. Material and method: A prospective study between January 2015 and December 2019, we evaluated the patients as a single group to assess the effectiveness of temporary hemiepiphysiodesis as a method of correction of genu valgum. The study included 29 patients with one patient was male and had unilateral valgus left knee and was lost in the follow up after removal of the plate and the remaining 28 patients were 22 bilateral 78.6% and 6 unilateral 22.4% (50 knees) four patients with right side14.3% and two patient left side 7.1% with coronal genu valgum deformity indicated for surgical treatment. There were 19 boys (67.8%) and 9 girls (32.2%) and all of them were treated by temporary hemiepiphysiodesis using eight-plate technique. The mean average age of the children at a time of the operation was 7.8±2.3`years (range, 4–12.5 years). Result: The entire patient had complete correction of the deformity. The mean follow-up was 31±7.8 months (range 20-48 months) after plate removal. Two patients reached skeletal maturity at the final follow up. The eightplates were inserted on the medial distal femur (MDF) in 6 patients (21.4%), in proximal tibia (MPT) in 6 (21.4%) patients and on both femur and tibia (MPT+MDF) in 16 patients (57.2%). All patients achieved complete deformity correction after plate removal mean duration 19±4.6 months (14-29 months) and the mean Intermalleolar distances before the procedure was 19.2±4.3 changed postoperative to 1.2±1 with P. value > 0.001 and the mean mLDFA changed from 79.2±5 to 87.2±1.5 and the P. value > 0.001 after the procedure. Conclusion: Temporary hemiepiphysiodesis using eight-Plates is a delicate, straight forward and successful strategy used to treat genu valgum by modulating growth. Slight overcorrection is alluring because of the rebound phenomenon, particularly in young patients with high development potential and risk groups, for example, obese children.
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