Comparison of Eight-plate with Reconstruction-plate in Temporary Hemiepiphysiodesis to Correct the Idiopathic Genu Valgum in Pediatrics

Document Type : RESEARCH PAPER


1 Bone and Joint Reconstruction Research Center, Shafa Orthopedic Hospital, Iran University of medical science, Tehran, Iran

2 Joint Reconstruction Research Center, Department of Orthopedics, Tehran University of Medical Sciences, Tehran, Iran

3 Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of medicine, Iran University of Medical Sciences, Tehran, Iran


Background: High cost of eight-plate makes it unavailable in many countries; therefore, developing an alternative
device for temporary hemiepiphysiodesis of knee deformities in pediatrics is valuable. In this study, we compared the
outcome of the eight-plate with the reconstruction-plate in this setting.
Methods: In this retrospective study, 109 skeletally immature patients (212 physes) who underwent temporary
hemiepiphysiodesis to correct idiopathic genu valgum were included. The eight-plate and reconstruction-plate were
used in 45 patients (90 physes) and 62 patients (122 physes), respectively. Outcome measures were the valgus angle,
medial proximal tibial angle (MPTA), the lateral distal femoral angle (LDFA), the joint-line convergence angle (JLCA),
and lower limb mechanical axis (LLMA).
Results: The baseline characteristics of the patients were comparable between the two plate groups. The mean
follow-up of the patients was 32.9 ± 15.1 months. The mean MPTA change was 2.7 ± 3.7º in the eight-plate group
and 2.1 ± 3.4º in the reconstruction-plate group (P=0.2). The mean LDFA improvement was 8 ± 3.7º in the eight-plate
group and 7.9 ± 3.5º in the reconstruction-plate group (P=0.61). The mean valgus correction was 10.7 ± 4.4º in the
eight-plate group and 10.4 ± 4.6º in the reconstruction-plate group (P=0.74). Moreover, the mean change of JLCA was
0.7 ± 1.3º in the eight-plate group and 0.8 ± 1.3º in the reconstruction-plate group (P=0.58). The postoperative LLMA
was comparable between the two study groups as well. In total, five postoperative complications were recorded in
this series, which included one case of screw loosening in each group, two cases of overcorrection, and one screw
breakage in the reconstruction-plate group.
Conclusion: The radiologic results and complications of the reconstruction-plate are comparable with the eight-plate.
Therefore, it can be safely and efficiently used in hemiepiphysiodesis to correct idiopathic genu valgum.
Level of evidence: III


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