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Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_5 | Pages 22 - 22
23 Apr 2024
Laufer A Frommer A Gosheger G Toporowski G Rölfing JD Antfang C Roedl R Vogt B
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Introduction

Coronal malalignment and leg length discrepancies (LLD) are frequently associated. Temporary hemiepiphysiodesis (tHED) is commonly employed for the correction of limb malalignment in skeletally immature patients. For treatment of LLD greater than 2 cm, lengthening with intramedullary legnthening nails is a safe and reliable technique. However, the combined application of these approaches in skeletally immature patients has not yet been investigated.

Materials & Methods

Retrospective radiological and clinical analysis of 25 patients (14 females, 11 males) who underwent intramedullary femoral lengthening with an antegrade PRECICE® lengthening nail as well as tHED of the distal femur and / or proximal tibia between 2014 and 2019. tHED was conducted by implantation of flexible staples (FlexTack™) either prior (n = 11), simultaneously (n = 10), or subsequently (n = 4) to femoral lengthening. The mean follow-up period was 3.7 years (±1.4).


Orthopaedic Proceedings
Vol. 103-B, Issue SUPP_6 | Pages 49 - 49
1 May 2021
Gigi R Kurien B Giles S Fernandes J
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Introduction. The purpose of our study was to retrospectively analyze our patients who were treated for FH and PFFD by means of guided growth temporary Hemiepiphysiodesis. We sought to determine the effectiveness of the procedure, as well as its success rates, complications, and rebound phenomena. Materials and Methods. We retrospectively reviewed the medical records and all routine preoperative and post operative long standing radiograph of all the FH and PFFD patients that were operated in our institute using guided growth hemiepiphysiodesis technique of distal femur or proximal tibia between 2007 to 2017. Results. 42 patients (28/FH, 14/PFFD) with 55 involved physis were included in the study. The mean duration of follow-up was 51.11 ± 27.56 months after the first operation. The average age at first plate insertion was 11.7 years and 50% of patients reached puberty by the time of data collection. 32 physes (21 FH, 11 PFFD) were operated due to pathological mLDFA with a mean angle correction of 6.24° for the FH group and 6° for the PFFD group and time-to-correction of 14.07 months and 11.56 months, respectively. 23 physes (14 FH, 9 PFFD) were operated due to pathological mMPTA with a mean angle correction of 4.43° for the FH group and 6.22° for the PFFD group with time-to-correction of 17.95 months and 20.35 months respectively. 40% (12/30) of patients, whose metalwork was removed, had a recurrence of the deformity, 7/21 [33.3%] in the FH group and 5/9 [55%] in the PFFD group. All required a second hemiepiphysiodesis operation. 2. nd. rebound was recorded in 3/21 (14%) FH patients and 2/9 (22%) PFFD patients. Conclusions. Temporary hemiepiphysiodesis is an effective treatment of angular deformities around the knees of FH and PFFD patients. With low complication rate and high risk of rebound phenomenon