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Journal articles on the topic 'Epiphysiodesis'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Petrova, Daria A., and Vladimir M. Kenis. "Assessment of comparative parameters of leg length discrepancy in children using temporary epiphysiodesis with 8-plates." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 10, no. 2 (July 12, 2022): 151–60. http://dx.doi.org/10.17816/ptors104405.

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BACKGROUND: Epiphysiodesis is used to correct the leg length discrepancy in children. The results of the effectiveness in different studies using epiphysiodesis with 8-plates. Forecasting is a fundamental provision of the methodology to apply epiphysiodesis. AIM: To determine the comparative effectiveness of temporary epiphysiodesis with 8-plates in correcting the difference in size of the lower limbs in children, depending on the age of the patient and the segment of epiphysiodesis. MATERIALS AND METHODS: We included data from a retrospective analysis of the results of correcting the leg length discrepancy using the method of guided growth in 94 patients. The technique included the use of two 8-plates. The calculation of comparative indicators was used, while the difference in the ratios of lengths of the epiphysiodesed and paired segments before epiphysiodesis and at the time of completion of guided growth (removal of metal structures) was determined as an indicator of the effectiveness of treatment. RESULTS: The maximum efficiency was observed with epiphysiodesis of the femur in children of the younger age group (a change of 7.59% in the length of the bone), the minimum was observed with epiphysiodesis of the tibia in children of the older age group (a change in length of 2.04%). The decrease in the effectiveness of femoral epiphysiodesis depending on age was linear, while that between the efficiency indicators in the younger and middle groups was 1.85%, and between the middle and older groups was 2.8%. In epiphysiodesis of the tibia, the difference between the efficiency indicators in the younger and middle age groups was 2.42%, and that between the middle and older age group was 0.34%. CONCLUSIONS: Temporary epiphysiodesis with 8-plates is effective in correcting the LLDs in children. The use of the comparative efficiency indicators obtained in different age groups allows us to plan the intervention more accurately and avoid unnecessary operations.

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2

Ogilvie, James W. "Epiphysiodesis." Journal of Pediatric Orthopaedics 6, no. 2 (March 1986): 147–49. http://dx.doi.org/10.1097/01241398-198603000-00005.

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3

Ogilvie, James W., and Kristine King. "Epiphysiodesis." Journal of Pediatric Orthopaedics 10, no. 6 (November 1990): 809–11. http://dx.doi.org/10.1097/01241398-199011000-00021.

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4

Kim, Sung Joon, Kuhn Sung Whang, Tae Seoung Ha, and Hee Cheul Park. "Percutaneous Epiphysiodesis." Journal of the Korean Orthopaedic Association 30, no. 3 (1995): 612. http://dx.doi.org/10.4055/jkoa.1995.30.3.612.

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5

Canale, S. T., T. A. Russell, and R. L. Holcomb. "Percutaneous Epiphysiodesis." Journal of Pediatric Orthopaedics 6, no. 2 (March 1986): 150–56. http://dx.doi.org/10.1097/01241398-198603000-00006.

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6

Terry Canale, S. "Percutaneous epiphysiodesis." Operative Techniques in Orthopaedics 3, no. 2 (April 1993): 161–65. http://dx.doi.org/10.1016/s1048-6666(06)80036-4.

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7

Atar, D., WB Lehman, AD Grant, and A. Strongwater. "Percutaneous epiphysiodesis." Journal of Bone and Joint Surgery. British volume 73-B, no. 1 (January 1991): 173. http://dx.doi.org/10.1302/0301-620x.73b1.1991759.

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8

Topoleski, Tamara A., Abraham Ganel, and Dennis P. Grogan. "Effect of Proximal Phalangeal Epiphysiodesis in the Treatment of Macrodactyly." Foot & Ankle International 18, no. 8 (August 1997): 500–503. http://dx.doi.org/10.1177/107110079701800807.

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The recommended treatment for macrodactyly of the foot will often include epiphysiodesis of the proximal phalanx in an attempt to halt further longitudinal growth of the toe. Nine patients who underwent open epiphysiodesis and debulking of the excess soft tissue involving 11 toes were reviewed to evaluate the effectiveness of this procedure. In 9 of 11 toes, overall length of the proximal phalanx did not change after surgery. Two toes demonstrated continued growth; one of these toes underwent a repeat epiphysiodesis of the phalanx, and the other foot underwent epiphysiodesis of the affected metatarsal. Overall, this surgical approach led to radiographic results that satisfied the surgical goals.

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9

Burger, K., S. Farr, J. Hahne, C. Radler, and R. Ganger. "Long-term results and comparison of the Green-Anderson and multiplier growth prediction methods after permanent epiphysiodesis using Canale’s technique." Journal of Children's Orthopaedics 13, no. 4 (August 2019): 423–30. http://dx.doi.org/10.1302/1863-2548.13.190024.

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Purpose The aim of the study was to evaluate the accuracy and radiographic outcomes of Canale’s method in patients with idiopathic leg-length discrepancy (LLD) following percutaneous epiphysiodesis. The accuracy of two common growth prediction methods was assessed. Methods A total of 18 patients with 26 affected bones (eight distal femur, two proximal tibia, five combined) were clinically and radiologically analyzed after reaching skeletal maturity. We compared the final effect of epiphysiodesis at maturity with the expected effect of epiphysiodesis before surgery; these measures were calculated using the Green-Anderson and multiplier methods, respectively. We furthermore compared pre- and postoperative frontal and lateral plane radiographs. Results The average LLD was 21.2 mm before surgery and 7.9 mm after epiphysiodesis. The final effect of both methods was not significantly different compared with the expected effect of epiphysiodesis before surgery. However, the prediction by the Green-Anderson method was closer to the definitive epiphysiodesis effect. The frontal plane radiographic deformity parameters did not change significantly after epiphysiodesis. The postoperative sagittal plane radiographic deformity parameters were in the normal range. Conclusion The Canale technique is a reliable method to reduce LLD in children. With regards to growth prediction, the Green-Anderson method using bone age seems to be more accurate than the multiplier method using chronological age. However, a relative over-estimation was observed with both methods in several cases, which might result in an insufficient correction. Level of Evidence IV, Therapeutic study

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10

Normandin, Brett M., David J. Tennent, Todd H. Baldini, Alesia M. Blanchard, and Jason T. Rhodes. "Epiphysiodesis Screw Bending." Orthopedics 40, no. 4 (March 15, 2017): e717-e720. http://dx.doi.org/10.3928/01477447-20170308-08.

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11

Mull, S. Curtiss, and Allison C. Scott. "FEMORAL EPIPHYSIODESIS/Response." Orthopedics 20, no. 4 (April 1997): 300. http://dx.doi.org/10.3928/0147-7447-19970401-04.

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12

Ledesma, Justin B., Tianyi Wang, Elizabeth Desmond, Meghan Imrie, James G. Gamble, and Lawrence A. Rinsky. "Endoscopic-assisted epiphysiodesis." Journal of Pediatric Orthopaedics B 25, no. 1 (January 2016): 24–30. http://dx.doi.org/10.1097/bpb.0000000000000230.

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13

Sinha, R., D. Weigl, E. Mercado, T. Becker, P. Kedem, and E. Bar-On. "Eight-plate epiphysiodesis." Bone & Joint Journal 100-B, no. 8 (August 2018): 1112–16. http://dx.doi.org/10.1302/0301-620x.100b8.bjj-2017-1206.r3.

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Aims Guided growth using eight-plates is commonly used for correction of angular limb deformities in growing children. The principle is of tethering at the physeal periphery while enabling growth in the rest of the physis. The method is also applied for epiphysiodesis to correct limb-length discrepancy (LLD). Concerns have been raised regarding the potential of this method to create an epiphyseal deformity. However, this has not been investigated. The purpose of this study was to detect and quantify the occurrence of deformities in the proximal tibial epiphysis following treatment with eight-plates. Patients and Methods A retrospective study was performed including 42 children at a mean age of 10.8 years (3.7 to 15.7) undergoing eight-plate insertion in the proximal tibia for correction of coronal plane deformities or LLD between 2007 and 2015. A total of 64 plates were inserted; 48 plates (34 patients) were inserted to correct angular deformities and 16 plates (8 patients) for LLD. Medical records, Picture Archive and Communication System images, and conventional radiographs were reviewed. Measurements included interscrew angle, lateral and medial plateau slope angles measured between the plateau surface and the line between the ends of the physis, and tibial plateau roof angle defined as 180° minus the sum of both plateau angles. Measurements were compared between radiographs performed adjacent to surgery and those at latest follow-up, and between operated and non-operated plateaus. Statistical analysis was performed using BMDP Statistical Software. Results Slope angle increased in 31 (49.2%) of operated epiphyses by a mean of 5° (1° to 23°) compared with 29 (31.9%) in non-operated epiphyses (p = 0.043). Roof angle decreased in 29 (46.0%) of operated tibias and in 25 (27.5%) of non-operated ones by a mean of 5° (1° to 18°) (p = 0.028). Slope angle change frequency was similar in patients with LLD, varus and valgus correction (p = 0.37) but roof angle changes were slightly more frequent in LLD (p = 0.059) and correlated with the change in inter screw angles (r = 0.74, p = 0.001). Conclusion The use of eight-plates in the proximal tibia for deformity correction and limb-length equalization causes a change in the bony morphology of the tibial plateau in a significant number of patients and the effect is more pronounced in the correction of LLD. Cite this article: Bone Joint J 2018;100-B:1112–16.

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McCarthy, James J., and Dennis S. Weiner. "Greater trochanteric epiphysiodesis." International Orthopaedics 32, no. 4 (March 10, 2007): 531–34. http://dx.doi.org/10.1007/s00264-007-0346-5.

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15

Troy, M., B. Shore, P. Miller, S. Mahan, D. Hedequist, B. Heyworth, J. Kasser, S. Spencer, and M. Glotzbecker. "A comparison of screw versus drill and curettage epiphysiodesis to correct leg-length discrepancy." Journal of Children's Orthopaedics 12, no. 5 (October 2018): 509–14. http://dx.doi.org/10.1302/1863-2548.12.180030.

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Purpose To compare two common surgical techniques of epiphysiodesis: drill/curettage epiphysiodesis (PDED) versus cross screw epiphysiodesis (PETS). The hypothesis is that the two techniques have similar efficacy but demonstrate differences in length of hospital stay (LOS), time to return to activity and complication rates. Methods A retrospective review of growing children and adolescents less than 18 years old who required an epiphysiodesis with leg-length discrepancy (LLD) of 2 cm to 6 cm with minimum two years of follow-up was conducted. Characteristics including age at surgery, gender, epiphysiodesis location, side, operative time, LOS and hardware removal were compared across treatment groups. LLD, expected growth remaining (EGR) and bone age were determined preoperatively and at most-recent visit. The correction ratio (change in EGR) was calculated along with a 95% confidence interval (CI) to assess if correction in leg length was achieved. Results A total of 115 patients underwent epiphysiodesis in the femur (53%), tibia (24%) or a combination (24%). The cohort was 47% male, with a mean age of 12.6 years (7.7 to 17.7) at surgery. Median follow-up was 3.7 years (2.0 to 12.7). In all, 23 patients underwent PETS and 92 patients had PDED. Both treatment groups achieved expected LLD correction. There was no significant difference in median operative time, complication rates or LOS. PETS patients returned to activity at a mean 1.4 months (interquartile range (IQR) 0.7 to 2.1) while PDED patients returned at a mean 2.4 months (IQR 1.7 to 3) (p < 0.001). Conclusion Effectiveness in achieving expected correction, LOS and operative time are similar between screw and drill/curettage epiphysiodesis. Patients undergoing PETS demonstrated a faster return to baseline activity than patients with PDED. Level of Evidence: III

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16

Brienza, P. D., L. A. L. Muzzi, A. C. C. Lacreta Jr, E. G. L. Alves, G. C. Guimarães, and R. A. L. Muzzi. "Electrocautery technique for proximal tibial epiphysiodesis in Labrador retriever puppies: experimental study." Arquivo Brasileiro de Medicina Veterinária e Zootecnia 68, no. 6 (December 2016): 1586–94. http://dx.doi.org/10.1590/1678-4162-9089.

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ABSTRACT There are few studies about the treatment options for cranial cruciate ligament rupture in growing dogs, especially with epiphysiodesis techniques. The aim of this study was to evaluate the electrocautery technique for proximal tibial epiphysiodesis in Labrador retriever puppies. The novel electrocautery technique was compared with the screw technique regarding the efficacy for tibial plateau leveling in growing dogs. Six healthy Labrador retriever puppies were divided into two groups. The screw technique was used in one group and the electrocautery technique was used in the other group. Both proximal tibial epiphysiodesis techniques for tibial plateau leveling were effective in achieving reduced tibial plateau angle and did not cause significant joint changes. The screw technique was more invasive and caused slightly greater morbidity than the electrocautery technique. The electrocautery technique seems to be a good alternative for proximal tibial epiphysiodesis in young dogs.

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Boyle, Jonathan, Marina R. Makarov, David A. Podeszwa, Jennifer A. Rodgers, Chan-Hee Jo, and John G. Birch. "Is Proximal Fibula Epiphysiodesis Necessary When Performing a Proximal Tibial Epiphysiodesis?" Journal of Pediatric Orthopaedics 40, no. 10 (July 29, 2020): e984-e989. http://dx.doi.org/10.1097/bpo.0000000000001642.

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18

Tolk, Jaap J., Deborah M. Eastwood, and Aresh Hashemi-Nejad. "Leg length discrepancy in patients with Perthes’ disease." Bone & Joint Journal 103-B, no. 11 (November 1, 2021): 1736–41. http://dx.doi.org/10.1302/0301-620x.103b11.bjj-2020-2583.r2.

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Aims Perthes’ disease (PD) often results in femoral head deformity and leg length discrepancy (LLD). Our objective was to analyze femoral morphology in PD patients at skeletal maturity to assess where the LLD originates, and evaluate the effect of contralateral epiphysiodesis for length equalization on proximal and subtrochanteric femoral lengths. Methods All patients treated for PD in our institution between January 2013 and June 2020 were reviewed retrospectively. Patients with unilateral PD, LLD of ≥ 5 mm, and long-leg standing radiographs at skeletal maturity were included. Total leg length, femoral and tibial length, articulotrochanteric distance (ATD), and subtrochanteric femoral length were compared between PD side and the unaffected side. Furthermore, we compared leg length measurements between patients who did and who did not have a contralateral epiphysiodesis. Results Overall, 79 patients were included, of whom 21 underwent contralateral epiphysiodesis for leg length correction. In the complete cohort, the mean LLD was 1.8 cm (95% confidence interval (CI) 1.5 to 2.0), mean ATD difference was 1.8 cm (95% CI -2.1 to -1.9), and mean subtrochanteric difference was -0.2 cm (95% CI -0.4 to 0.1). In the epiphysiodesis group, the mean LLD before epiphysiodesis was 2.7 cm (95% CI 1.3 to 3.4) and 1.3 cm (95% CI -0.5 to 3.8) at skeletal maturity. In the nonepiphysiodesis group the mean LLD was 2.0 cm (95% CI 0.5 to 5.1; p = 0.016). The subtrochanteric region on the PD side was significantly longer at skeletal maturity in the epiphysiodesis group compared to the nonepiphysiodesis group (-1.0 cm (95% CI -2.4 to 0.6) vs 0.1 cm (95% CI -1.0 to 2.1); p < 0.001). Conclusion This study demonstrates that LLD after PD originates from the proximal segment only. In patients who had contralateral epiphysiodesis to balance leg length, this is achieved by creating a difference in subtrochanteric length. Arthroplasty surgeons need to be aware that shortening of the proximal femur segment in PD patients may be misleading, as the ipsilateral subtrochanteric length in these patients can be longer. Therefore, we strongly advise long-leg standing films for THA planning in PD patients in order to avoid inadvertently lengthening the limb. Cite this article: Bone Joint J 2021;103-B(11):1736–1741.

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McCarthy, James J., Thomas Burke, and M. Christine McCarthy. "Need for Concomitant Proximal Fibular Epiphysiodesis When Performing a Proximal Tibial Epiphysiodesis." Journal of Pediatric Orthopaedics 23, no. 1 (January 2003): 52–54. http://dx.doi.org/10.1097/01241398-200301000-00010.

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20

Willegger, Madeleine, Markus Schreiner, Alexander Kolb, Reinhard Windhager, and Catharina Chiari. "Epiphysiodesis for the treatment of tall stature and leg length discrepancy." Wiener Medizinische Wochenschrift 171, no. 5-6 (March 18, 2021): 133–41. http://dx.doi.org/10.1007/s10354-021-00828-8.

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SummaryPainful orthopedic conditions associated with extreme tall stature and leg length discrepancy (LLD) include back pain and adopting bad posture. After failure of conservative treatment options, blocking of the growth plates (epiphysiodesis) around the knee emerged as gold standard in patients with tall stature and LLD in the growing skeleton. Surgical planning includes growth prediction and evaluation of bone age. Since growth prediction is associated with a certain potential error, adequate planning and timing of epiphysiodesis are the key for success of the treatment. LLD corrections up to 5 cm can be achieved, and predicted extreme tall stature can be limited. Percutaneous epiphysiodesis techniques are minimally invasive, safe and efficient methods with low complication rates. In general, a multidisciplinary approach should be pursued when treating children and adolescents with tall stature.

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Normandin, Brett M., David J. Tennent, Todd H. Baldini, Alesia M. Blanchard, and Jason T. Rhodes. "Mechanical Testing of Epiphysiodesis Screws." Orthopedics 41, no. 2 (January 29, 2018): e240-e244. http://dx.doi.org/10.3928/01477447-20180123-01.

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McClure, PhilipK, and JohnE Herzenberg. "Epiphysiodesis: Not just for equalization." Journal of Limb Lengthening & Reconstruction 8, no. 1 (2022): 1. http://dx.doi.org/10.4103/jllr.jllr_21_22.

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23

Marcinko, DE, N. Field, and G. Bryan. "Epiphysiodesis. An adjunctive surgical technique." Journal of the American Podiatric Medical Association 75, no. 11 (November 1, 1985): 593–96. http://dx.doi.org/10.7547/87507315-75-11-593.

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24

Stevens, Peter M., and Ralph M. Belle. "Screw Epiphysiodesis for Ankle Valgus." Journal of Pediatric Orthopaedics 17, no. 1 (January 1997): 9–12. http://dx.doi.org/10.1097/01241398-199701000-00003.

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25

Macnicol, M. F., and M. S. Gupta. "EPIPHYSIODESIS USING A CANNULATED TUBESAW." Journal of Bone and Joint Surgery. British volume 79-B, no. 2 (March 1997): 307–9. http://dx.doi.org/10.1302/0301-620x.79b2.0790307.

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KRAMEK, B. A., L. J. WALLACE, J. A. DOWDLE, and D. M. BARNES. "Cryosurgical Epiphysiodesis in the Dog." Veterinary Surgery 15, no. 1 (January 1986): 79–84. http://dx.doi.org/10.1111/j.1532-950x.1986.tb00181.x.

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Angélico, A. C. C., L. M. Garcia, T. R. Icuma, C. F. Herrero, and D. A. Maranho. "The results of osteotomy at the base of femoral neck with osteoplasty in restoration of abductor function and strength in slipped capital femoral epiphysis." Bone & Joint Journal 100-B, no. 11 (November 2018): 1524–32. http://dx.doi.org/10.1302/0301-620x.100b11.bjj-2018-0273.r1.

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Aims The aims of this study were to evaluate the abductor function in moderate and severe slipped capital femoral epiphysis (SCFE), comparing the results of a corrective osteotomy at the base of the femoral neck and osteoplasty with 1) in situ epiphysiodesis for mild SCFE, 2) contralateral unaffected hips, and 3) hips from healthy individuals. Patients and Methods A total of 24 patients (mean age 14.9 years (sd 1.6); 17 male and seven female patients) with moderate or severe SCFE (28 hips) underwent base of neck osteotomy and osteoplasty between 2012 and 2015. In situ epiphysiodesis was performed in seven contralateral hips with mild slip. A control cohort was composed of 15 healthy individuals (mean age 16.5 years (sd 2.5); six male and nine female patients). The abductor function was assessed using isokinetic dynamometry and range of abduction, with a minimum one-year follow-up. Results We found no differences in mean peak abductor torque between the hips that underwent osteotomy and those that received in situ epiphysiodesis (p = 0.63), but the torque was inferior in comparison with contralateral hips without a slip (p < 0.01) and hips from control individuals (p < 0.001). The abduction strength was positively correlated with the range of hip abduction (R = 0.36; p < 0.001). Conclusion Although the abductor strength was not restored to normal levels, moderate and severe SCFE treated with osteotomy at the base of the femoral neck and osteoplasty showed abductor function similar to in situ epiphysiodesis in hips with less severe displacement. Cite this article: Bone Joint J 2018;100-B:1524–32.

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Bayhan, Ilhan A., Ali F. Karatas, Kenneth J. Rogers, J. Richard Bowen, and Mihir M. Thacker. "Comparing Percutaneous Physeal Epiphysiodesis and Eight-Plate Epiphysiodesis for the Treatment of Limb Length Discrepancy." Journal of Pediatric Orthopaedics 37, no. 5 (2017): 323–27. http://dx.doi.org/10.1097/bpo.0000000000000647.

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Shahrestani, S., M. R. Makarov, C. H. Jo, and J. G. Birch. "Comparison of Moseley and Rotterdam straight-line graphs in predicting leg lengths and leg-length discrepancy at maturity." Journal of Children's Orthopaedics 13, no. 5 (October 1, 2019): 536–42. http://dx.doi.org/10.1302/1863-2548.13.190086.

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Purpose One method of predicting leg-length discrepancy at maturity is the Moseley straight-line graph. Beumer et al developed an alternative graph, using a more modern Dutch population. The purpose of this study was to compare the prediction accuracy of these two graphs in a cohort of patients treated at our institution using epiphysiodesis. Methods We identified 76 patients treated using epiphysiodesis for leg-length discrepancy who were followed to maturity and had adequate preoperative radiographic assessment for straight-line graph construction. We compared predicted long leg length (after epiphysiodesis), short leg length, and residual leg-length discrepancy to actual outcome for both methods, using both chronological and skeletal ages. Results Both methods were more accurate using skeletal age rather than chronological age. The Rotterdam graph showed modest improved accuracy compared to the Moseley graph in developmental aetiologies and in Hispanic patients. Using a difference of one centimetre in prediction error as clinically relevant (long leg [after epiphysiodesis], short leg, and leg-length discrepancy in each of the 76 patients, 228 predictions), we found comparable predictions in 171, more accurate prediction using the Rotterdam in 32, and using the Moseley in 25 predictions. Conclusions Straight-line graphs provide a generally more accurate prediction of leg lengths at maturity by virtue of multiple preoperative evaluations. The Rotterdam straight-line graph was equal to or superior to the Moseley graph in most patients in this cohort. Use of skeletal age resulted in more accurate predictions than chronological age. Clinicians should remain familiar with the concept and use of the straight-line graph. Level of evidence III, case-control study.

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Pozdnikin, Ivan Y., Vladimir E. Baskov, Dmitry B. Barsukov, Pavel I. Bortulev, Ekaterina A. Kostomarova, and Khisrav D. Imomov. "Trochanteric epiphysiodesis in complex treatment of children with hip pathology: analysis of preliminary results." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 8, no. 3 (October 6, 2020): 249–58. http://dx.doi.org/10.17816/ptors33942.

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Background. The relative overgrowth of the greater trochanter is one of the most common deformities of the proximal femur in association with several disorders of the hip joint. Aim. To analyze the dynamics of proximal femoral growth after trochanteric epiphysiodesis as well as to determine the options for using this method in the complex treatment of children with hip pathology. Materials and methods. We analyzed the data of clinical and radiological examinations and surgical treatment (permanent trochanteric epiphysiodesis with metal fixation) outcomes for 43 (52 joints) patients aged 412 years with a developing high position of the greater trochanter. Results. The surgery enabled slowing down of the growth of the greater trochanter on the side of intervention by (average) 50% (p 0.05), although the values of the neck-shaft angle both on the affected side and the side opposite to it did not change (p 0.05). Conclusion. In moderate disorders of the growth plate of the femoral head epiphysis, trochanteric epiphysiodesis can prevent the progression and, in some cases, correct disturbed ratios of the hip joint, thereby avoiding the need for larger surgical interventions.

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Frydrýšek, Karel, Daniel Čepica, Tomáš Halo, Ondřej Skoupý, Leopold Pleva, Roman Madeja, Jana Pometlová, et al. "Biomechanical Analysis of Staples for Epiphysiodesis." Applied Sciences 12, no. 2 (January 9, 2022): 614. http://dx.doi.org/10.3390/app12020614.

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Limb asymmetry can, and often does, cause various health problems. Blount bone staples (clips) are used to correct such uneven growth. This article analyzes the performance of a biomechanical staple during bone (tibia) growth arrest. The staples considered in this study were made of 1.4441 stainless steel, the model of tibia consisted of two materials representing corticalis and spongiosis. Hooke’s law was used for modeling materials’ behaviors for finite element analysis (FEA). The maxima of stress and total staple displacement were evaluated using the finite element method and verification of the results, along with the determination of the maximum loading (growing) force that the staples are capable of withstanding, was performed experimentally. The presented method can be used to determine the safety and usability of staples for bone growth arrest. According to our results, the design of Blount staples considered in this paper is safe and suitable for orthopedic treatment.

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Ghanem, Ismat, Joseph A. Karam, and Roger F. Widmann. "Surgical epiphysiodesis indications and techniques: update." Current Opinion in Pediatrics 23, no. 1 (February 2011): 53–59. http://dx.doi.org/10.1097/mop.0b013e32834231b3.

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Métaizeau, Jean-Paul, John Wong-Chung, Hélène Bertrand, and Philippe Pasquier. "Percutaneous Epiphysiodesis Using Transphyseal Screws (PETS)." Journal of Pediatric Orthopaedics 18, no. 3 (May 1998): 363–69. http://dx.doi.org/10.1097/01241398-199805000-00018.

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Nouth, Fred, and Leonard A. Kuo. "Percutaneous Epiphysiodesis Using Transphyseal Screws (PETS)." Journal of Pediatric Orthopaedics 24, no. 6 (November 2004): 721–25. http://dx.doi.org/10.1097/01241398-200411000-00023.

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35

Irani, Roshen N., Abraham H. Rosenzweig, Howard B. Cotler, and Edwards P. Schwentker. "Epiphysiodesis in Slipped Capital Femoral Epiphysis." Journal of Pediatric Orthopaedics 5, no. 6 (November 1985): 661–64. http://dx.doi.org/10.1097/01241398-198511000-00006.

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Irani, Roshen. "Epiphysiodesis in Slipped Capital Femoral Epiphysis." Journal of Pediatric Orthopaedics 6, no. 6 (November 1986): 754. http://dx.doi.org/10.1097/01241398-198611000-00036.

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37

Kemnitz, Stefan, Pierre Moens, and Guy Fabry. "Percutaneous epiphysiodesis for leg length discrepancy." Journal of Pediatric Orthopaedics B 12, no. 1 (January 2003): 69–71. http://dx.doi.org/10.1097/01202412-200301000-00013.

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38

Horton, Greg A., and Brad W. Olney. "PERCUTANEOUS EPIPHYSIODESIS OF THE LOWER EXTREMITY." Southern Medical Journal 85, Supplement (September 1992): 3S—66. http://dx.doi.org/10.1097/00007611-199209001-00182.

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39

Kemnitz, Stefan, Pierre Moens, and Guy Fabry. "Percutaneous epiphysiodesis for leg length discrepancy." Journal of Pediatric Orthopaedics, Part B 12, no. 1 (January 2003): 69–71. http://dx.doi.org/10.1097/00009957-200301000-00013.

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CANALE, S. TERRY, and CLAIBORNE A. CHRISTIAN. "Techniques for Epiphysiodesis About the Knee." Clinical Orthopaedics and Related Research &NA;, no. 255 (June 1990): 81???85. http://dx.doi.org/10.1097/00003086-199006000-00012.

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41

Stevens, Peter M. "Invalid Comparison Between Methods of Epiphysiodesis." Journal of Pediatric Orthopaedics 38, no. 1 (January 2018): e29-e30. http://dx.doi.org/10.1097/bpo.0000000000001020.

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42

Edmonds, Eric W., and Peter J. Stasikelis. "Percutaneous Epiphysiodesis of the Lower Extremity." Journal of Pediatric Orthopaedics 27, no. 6 (September 2007): 618–22. http://dx.doi.org/10.1097/bpo.0b013e31814254b4.

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43

Inan, Muharrem, Gilbert Chan, Aaron G. Littleton, Paul Kubiak, and J. Richard Bowen. "Efficacy and Safety of Percutaneous Epiphysiodesis." Journal of Pediatric Orthopaedics 28, no. 6 (September 2008): 648–51. http://dx.doi.org/10.1097/bpo.0b013e3181832475.

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Widiwanto, Bambang. "PERBEDAAN PANJANG TUNGKAI (LEG LENGTH DISCREPANCY) DALAM ORTHOPAEDI." Saintika Medika 10, no. 1 (March 20, 2017): 10. http://dx.doi.org/10.22219/sm.v10i1.4143.

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Abstract:

Masalah leg length discrepancy dalam orthopaedi bukan hanya permasalahan kosmetik, tetapi juga permasalahan fungsional. Ada empat jenis terapi yang memungkinkan untuk menyeimbangkan panjang tungkai : (1) sepatu tambahan atau konversi dengan prostetik (2) epiphysiodesis pada sisi tungkai yang panjang (3) pemendekan pada sisi tungkai yang panjang (4) pemanjangan pada sisi tungkai yang pendek. Kombinasi antara pemanjangan pada ipsilateral dan epiphysiodesis pada kontralateral dapat digunakan pada ketidaksamaan yang bermakna untuk mengurangi jumlah pemanjangan yang dibutuhkan. (Champbell,2007) Semua tipe alat dan teknik pemanjangan tungkai memiliki komplikasi. (1) Pin Track Infection (2) berhubungan dengan otot, terjadi Flexion contracture (3) Subluksasi/ dislokasi sendi (4) infeksi, pseudoarthrosis, plate patah dan malunion. (Stanitski ,1999) Keywords : Leg length discrepancy, terapi, komplikasi.

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45

Mesquita, Luciane Dos Reis, Leonardo Augusto Lopes Muzzi, Amália Turner Giannico, Ruthnéa Aparecida Lázaro Muzzi, Juliana Fonseca Monteiro, and Paula Desjardins Brienza. "Proximal Tibial Epiphysiodesis in a Growing Dog." Acta Scientiae Veterinariae 44, no. 1 (January 16, 2016): 4. http://dx.doi.org/10.22456/1679-9216.84520.

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Background: It is believed that the inclined tibial plateau angle to be a major cause of cranial cruciate ligament (CCL) rupture, and the treatment of this disease is the tibial plateau leveling for decrease the cranial tibial thrust. However, there are breeds predisposed to rupture of the cranial cruciate ligament and in this patterns breed the tibial plateau is more inclined due to the conformation of the limb. The aim of this communication was to evaluate the effectiveness of the locking screw and cauterizing the growth plate of the tibial plateau as a preventive method of cranial cruciate ligament rupture. Case: In a young dog, one stifle joint randomly chosen for placing a screw in order to block the tibial plateau growth line. There was placed a 3.5 mm x 20 mm cancellous bone screw in the dorsocranial surface of the tibial plateau of the left hindlimb. Two months after the first surgical intervention, the contralateral limb was cauterized in the tibial plateau growth line. Electrocauterization was performed with a spatula electrode set at 60 watts, performing ablation on the cranial third of the tibial plateau physis with access to the medial and lateral surfaces of the proximal tibia. The electrode was placed against the physis for 10 seconds at each site. Both members were followed radiographically to measure the tibial plateau angle and observed the angle reduction. After 30 and 60 days post-surgery, the tibial plateau angle in left hindlimb decreased to 11o and -4o, respectively. However, the decrease plateau tibial angle was intense and severe and the screw was removed of the bone. However, even with the proximal tibial physis still open, withdrawing the screw did not alter the tibial plateau angle, which remained at -4º until the animal reached adulthood. The right left hindlimb was used as a control until the dog was 6 months old, when the tibial plateau angle exhibited a 26°. With the electrocauterization technique the tibial plateau angle decreased to 18° and 16° at 30 and 60 days after surgery, respectively, remaining at this last value until the animal completed its growth. Discussion: In the animals with cranial cruciate ligament rupture is indicate same surgical procedures like tibial plateau leveling osteotomy. In these cases, the recommended tibial plateau angle is aproximattely 5o. This study sought to block the line of growth of the tibial plateau to be reached an angle of approximately 5o. Epiphysiodesis technique with screw was already described for treating CCL rupture in young dogs, and the tibial plateau slope was reduced in all dogs studied. The surgical technique used was effective in blocking the physis; however, we observed that the tibial plateau slope was excessively modified and the screw was removed. This fact is explained by the dog’s immaturity, since the plateau leveling occurs more intensively in very young dogs. In epiphysiodesis using the electrocauterization technique, the same surgical principle of juvenile pubic symphysiodesis for treating coxofemoral dysplasia was used. However, in the current pilot study, it was unable to achieve the desired tibial plateau slope with this technique, possibly due to performing the procedure at an age in which the proximal tibial physis would have limited functional capacity. In this study, there was a reduction in the angle of the tibial plateau in both the techniques. However, further studies should be conducted to in order to confirm the actual effectiveness of both techniques described in this report. Keywords: cranial cruciate ligament, locking screw, electrocauterization, stifle joint

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Campbell, Tanner, L. Wade Faulk, Kristen Vossler, Ezra Goodrich, Andy Lalka, Sarah E. Sibbel, and Micah K. Sinclair. "Ulnar Epiphysiodesis: Success of the Index Procedure." Journal of Pediatric Orthopaedics 42, no. 3 (January 13, 2022): 158–61. http://dx.doi.org/10.1097/bpo.0000000000001993.

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&NA;. "ALLOGRAFT EPIPHYSIODESIS FOR SLIPPED CAPITAL FEMORAL EPIPHYSIS." Journal of Pediatric Orthopaedics 16, no. 4 (July 1996): 554. http://dx.doi.org/10.1097/01241398-199607000-00036.

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Schmidt, Thomas L., William G. Cimino, and F. Glen Seidel. "Allograft Epiphysiodesis for Slipped Capital Femoral Epiphysis." Clinical Orthopaedics and Related Research 322 (January 1996): 61–76. http://dx.doi.org/10.1097/00003086-199601000-00008.

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49

Olive, Mélanie, Alexandre Caron, Alexandre Fournet, and Maïa Vanel. "Arthroscopically Guided Proximal Tibial Epiphysiodesis Screw Placement as Treatment of a Bilateral Partial Cranial Cruciate Ligament Injury in a Juvenile Dog." VCOT Open 03, no. 02 (July 2020): e112-e118. http://dx.doi.org/10.1055/s-0040-1716821.

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AbstractThis study aimed to describe surgical technique of arthroscopically guided proximal tibial epiphysiodesis screw placement in the treatment of a bilateral partial cranial cruciate ligament (CrCL) rupture in a 5.6-month-old Golden Retriever. A 19-kg, 5.6-month-old female Golden Retriever was diagnosed with bilateral partial CrCL rupture. Proximal tibial epiphysiodesis was performed bilaterally under arthroscopic guidance. Arthroscopic stifle joint inspection was performed bilaterally with a 2.7 mm arthroscope. A medial port at the level of the distal one-third of the patella was used as camera portal. A lateral instrument port was positioned at the level of the distal one-third of the patella. A 3.0 mm diameter headless cannulated self-compressive screw was placed into the centre of the tibial cranial intercondyloid area as parallel as possible to the tibial shaft axis under arthroscopic control. Screw head was buried. Arthroscopic guidance allowed good accuracy in screw placement, specifically in its insertion point. However, the screw orientation was less satisfactory. The tibial plateau angle progressively decreased in both stifles to achieve 15 degrees on the left and 16 degrees on the right at the last follow-up. A varus deformity developed on both stifles. No clinical consequences were observed. Recurrence of right pelvic lameness occurred 1 year postoperatively because of a medial meniscal lesion, which necessitated partial caudal meniscectomy. Arthroscopically guided proximal tibial epiphysiodesis is technically feasible and is a minimally invasive treatment of CrCL injury in a juvenile dog.

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Picavet, Pierre P., Bernard Bouvy, Martin Hamon, Michael Lefebvre, and Marc Balligand. "Use of Epiphysiodesis as Treatment for a Proximal Physeal Tibial Fracture in a Dog." VCOT Open 02, no. 01 (January 2019): e55-e59. http://dx.doi.org/10.1055/s-0039-1692170.

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Objective The aim of this study was to describe the use of epiphysiodesis by the means of a screw to treat a proximal tibial Salter–Harris II fracture associated with a tibial tuberosity avulsion in a 4.5-month-old Airedale Terrier. Study design A healing proximal tibial epiphyseal fracture was observed after a 10-day period. Tibial plateau angle was 40°. The fracture was treated by the insertion of a fluoroscopy-guided 3.5-mm cancellous screw. Results Successful healing of fractures and levelling of tibia plateau were obtained. Final tibial plateau angle was 8°. At long-term follow-up (18 months), owners reported sustained and full functional recovery. Conclusion Prior to ossification of the proximal tibial physis, epiphysiodesis with a screw can be used as a treatment of sub-acute, moderately displaced, Salter–Harris I or II fractures.

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