Efficacy and late complications of percutaneous epiphysiodesis with transphyseal screws
- B. Ilharreborde, MD, MS, Orthopaedic Surgeon1;
- E. Gaumetou, MD, Orthopaedic Surgeon1;
- P. Souchet, MD, Orthopaedic Surgeon1;
- F. Fitoussi, MD, Orthopaedic Surgeon1;
- A. Presedo, MD, Orthopaedic Surgeon1;
- G. F. Penneçot, MD, Orthopaedic Surgeon1; and
- K. Mazda, MD, Orthopaedic Surgeon, Chief of Department1
- Correspondence should be sent to Dr B. Ilharreborde; e-mail: i_brice{at}hotmail.com
Abstract
Percutaneous epiphysiodesis using transphyseal screws (PETS) has been developed for the treatment of lower limb discrepancies with the aim of replacing traditional open procedures. The goal of this study was to evaluate its efficacy and safety at skeletal maturity. A total of 45 consecutive patients with a mean skeletal age of 12.7 years (8.5 to 15) were included and followed until maturity. The mean efficacy of the femoral epiphysiodesis was 35% (14% to 87%) at six months and 66% (21% to 100%) at maturity. The mean efficacy of the tibial epiphysiodesis was 46% (18% to 73%) at six months and 66% (25% to 100%) at maturity. In both groups of patients the under-correction was significantly reduced between six months post-operatively and skeletal maturity. The overall rate of revision was 18% (eight patients), and seven of these revisions (87.5%) involved the tibia. This series showed that use of the PETS technique in the femur was safe, but that its use in the tibia was associated with a significant rate of complications, including a valgus deformity in nine patients (20%), leading us to abandon it in the tibia. The arrest of growth was delayed and the final loss of growth at maturity was only 66% of that predicted pre-operatively. This should be taken into account in the pre-operative planning.
- Lower limb discrepancy
- Epiphysiodesis
- Percutaneous transphyseal screw
- Paediatrics
- Growth modulation
- Lower limb discrepancy
- Surgical technique
Footnotes
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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
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Supplementary material. A table detailing the femoral and tibial measurements and lower limb discrepancy of all 45 patients in the study by gender, site and skeletal age is available with the electronic version of this article on our website www.jbjs.org.uk
- Received April 27, 2011.
- Accepted October 11, 2011.
- ©2012 British Editorial Society of Bone and Joint Surgery
