Angular Deformities of the Knee in Children Treated with Guided Growth
https://doi.org/10.5704/MOJ.2107.005
- Author:
Jamil K
1
;
Yahaya MY
2
,
3
;
Abd-Rasid AF
1
;
Ibrahim S
1
;
Abdul-Rashid AH
1
Author Information
1. Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
2. Department of Orthopaedics, Universiti Teknologi Mara, Batu Caves, Malaysia&
3. Faculty of Medicine, Universiti Teknologi Mara, Sungai Buloh, Malaysia
- Publication Type:Journal Article
- Keywords:
bone plate, genu valgum, genu varum, growth modulation, growth plate
- From:Malaysian Orthopaedic Journal
2021;15(No.2):26-35
- CountryMalaysia
- Language:English
-
Abstract:
Introduction: The guided growth technique is an alternative
to corrective osteotomy for treating angular deformities of
the extremities. It has the advantage of being minimally
invasive and is effective in a growing child. This study
reports on the outcome of guided growth technique using a
plate in correcting knee angular deformities.
Materials and methods: We conducted a retrospective study
of children with angular deformity of the knee treated by the
guided growth technique from January 2010 to December
2015 in a tertiary centre. The guided growth technique was
done using either the flexible titanium plate (8-plate) or the 2-
hole reconstruction plate. Correction of deformity was
assessed on radiographs by evaluating the mechanical axis
deviation and tibiofemoral angle. The implants were removed
once deformity correction was achieved.
Results: A total of 17 patients (27 knees) were evaluated.
Twenty-two knees (81.5%) achieved complete correction of
the deformity. The median age was 4.0 (interquartile range
3.0-6.0) years and the median Body Mass Index (BMI) was
26.0 (25.0-28.0). There were 7 unilateral and 10 bilateral
deformities with different pathologies (14 tibia vara, 3 genu
valgus). The median rate of correction was 0.71° per month.
One patient (1 knee) had screw pull-out and two patients (4
knees) had broken screws in the proximal tibia. Three
patients (5 knees) failed to achieve complete correction and
were subsequently treated with corrective osteotomies. Out
of five patients (8 knees) who were followed-up for at least
12 months after removal of hardware, two had rebound
deformities. No permanent growth retardation occurred in
our patients.
Conclusion: Our outcome for guided growth to correct knee
angular deformity was similar to other studies. Guided
growth is safe to perform in children below 12 years old and
has good outcome in idiopathic genu valgus and Langeskiold
II for tibia vara. Patients should be observed for recurrence
until skeletal maturity following implant removal.
- Full text:16.2021my1171.pdf
