Correction of pediatric angular deformities in lower limbs through guided growth using a novel flexible plate system

Daniel Quintero; Miguel Galbán; Cesar Gil

doi:10.1016/j.otsr.2022.103406

Correction of pediatric angular deformities in lower limbs through guided growth using a novel flexible plate system

Orthop Traumatol Surg Res. 2023 May;109(3):103406. doi: 10.1016/j.otsr.2022.103406. Epub 2022 Sep 13.

Authors

Daniel Quintero¹, Miguel Galbán², Cesar Gil²

Affiliations

¹ Pediatric orthopedics fellowship program, Faculty of Medicine, Universidad Pontificia Bolivariana, Calle 78 B # 72 A 109, Medellín, Colombia. Electronic address: surgeon.bone.joint@gmail.com.
² Department of Children's orthopedics, Fundación Clínica Noel, CORA Group, Calle 14 N° 43 B-146, Medellín, Colombia.

PMID: 36108819
DOI: 10.1016/j.otsr.2022.103406

Abstract

Introduction: Tension band plates (TBP) for guided growth (GG) are the gold standard treatment for angular deformities around the knee. EPIFLEX® is a novel flexible TBP that adjusts to the patient's bone anatomy.

Hypothesis: GG using a flexible TBP produces satisfactory correction rates with minor complications in the pediatric population with angular deformities around the knee.

Materials and methods: A retrospective evaluation of 33 patients (60 knees) treated for genu varum and valgum with hemiepiphysiodesis using a flexible TBP between 2017 and 2020 was performed. The study aimed to assess correction and complication rates; patients who completed treatment were included regardless of the follow-up times after implant removal.

Results: Thirteen females and 20 males with a median age of 10 years were included. The median treatment duration and follow-up were 10 and 22 months. The median monthly rate of change of mLDFA and mMPTA was 0.67° and 0.57°, respectively. A successful correction was achieved in 90% of the cases. There were no cases of infection or implant failure. Four cases presented overcorrection and two undercorrection; no significant relation with deformity or obesity was found.

Discussion: GG using this flexible TBP showed satisfactory correction rates with a low incidence of complications and no implant failure. It provides flexibility through good adaptability to the bone anatomy and mobility of the screws avoiding implant protrusion or breakage.

Level of evidence: IV; observational descriptive case series.

Keywords: Genu valgum; Genu varum; Guided growth; Hemiepiphysiodesis; Physis; Tension band plate.