Guided growth with a noncannulated screw–plate system for angular deformity of the knee

Abstract

We assessed the result of guided growth for an angular knee deformity using a 3.5-mm noncannulated screw-plate system. Twenty-seven patients with angular deformities (10 distal femora, 13 proximal tibiae, and four both areas) underwent this procedure with the reconstruction plate and two noncannulated screws. Average age at the time of the procedure was 7.8 years and the average follow-up was 25.7 months. Except for one patient (two knees), 25 of 27 deformities showed a resolved outcome with a neutral alignment. The mechanical lateral distal femoral angle changed an average of 8.3° for 13 months and the medial proximal tibial angle changed an average of 7.7° for 11.8 months in the neutral state. The mean angle between the two screws was -2° in immediate postoperative radiographs and 23° in radiographs taken at the latest follow-up. Two patients showed a rebound outcome and one showed a failure of no correction. There was a superficial infection, but no mechanical failure of the screw and the plate was observed. The noncannulated screw-plate system may play a similar role of guided growth, to correct angular knee deformity, although a large series study with a long follow-up is required for a definitive conclusion.