Role of hemi-epiphysiodesis using 8-plate system in the correction of coronal plane deformities around the knee

Abstract

Introduction: Angular deformities around the knee in children is a common finding, these deformities are from diverse group of etiologies. Most of these deformities are physiological in nature corresponding to the changes in the alignment of tibio-femoral angle from birth to adolescence. Angular deformities can also be developed due to pathological causes like skeletal dysplasias, metabolic bone disorders, Blount’s disease and trauma. Osteotomies were the mainstay of treatment for correcting deformities in both adults and children been replaced by Hemiepiphysiodesis using 8 plates having less complication rate. Materials and Methods: A total of 49 knees (35 genu valgum, 14 genu varum) of 30 patients were studied. 8 -plates were used for correction of coronal plane deformities around the knee. All cases were followed for minimum period of 12 months. Preoperative clinical and radiological measurements were compared to post-operative measurements. Results: There was statistically significant improvement in clinical and radiological outcome measures. In genu valgum group preoperative mean Tibio-femoral angle (TFA) improved from 24.16 to 8.36. Mean Mechanical axis deviation (MAD) improved from 4.26 to 1.09. Rate of correction of TFA is 1.1/month, rate of correction of MAD is 0.22/month. In genu varum group preoperative mean TFA improved from 34.58 to 21.47. Mean MAD improved from 4.92 to 0.63. Rate of correction of TFA is 0.77/ month, rate of correction of MAD is 0.12/month. Conclusion: Hemi-epiphysiodesis using 8-plate systemin the correction of coronal plane deformities around the knee is a safe and effective procedure. Keywords: Hemiepiphysiodesis, Guided growth modulation, Genu varum, Genu valgum.