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VOLUME 9 , ISSUE 1 ( April, 2014 ) > List of Articles

Original Article

Epiphysiodesis for limb length discrepancy: a comparison of two methods

L. V. Babu, O. Evans, A. Sankar, A. G. Davies, S. Jones, J. A. Fernandes

Keywords : Epiphysiodesis, Limb length discrepancy, Canale, Metaizeau

Citation Information : Babu LV, Evans O, Sankar A, Davies AG, Jones S, Fernandes JA. Epiphysiodesis for limb length discrepancy: a comparison of two methods. 2014; 9 (1):1-3.

DOI: 10.1007/s11751-013-0180-9

License: CC BY-NC-SA 4.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2014; The Author(s).


Abstract

A retrospective review of 42 patients from 1999 to 2008 with at least 1-year follow-up was performed. The type and location of epiphysiodesis, average operative time and hospital stay, complications, timing and the final limb length discrepancy (LLD) were recorded. Computer tomography scanograms and mechanical axis view with grids were done to assess LLD. Twenty-six patients underwent Canale type epiphysiodesis compared with 14 receiving Metaizeau screw epiphysiodesis. The average operation time for Canale type was 42 and 45 min for screw epiphysiodesis. In the Canale group, there was a mean reduction in 2.5 cm in LLD from 3.7 to 1.2 cm over an average follow-up of 2.1 years. There were 4 minor and 2 major complications with a 92 % success rate defined as achieving the desired discrepancy correction. In the screw epiphysiodesis group, the mean change was 1.8 cm from 3.2 to 1.4 cm, over 2.2 years with 2 minor and 2 major complications and a success rate of 85 %. Percutaneous epiphysiodesis by any method is a reliable, minimally invasive method with minimal morbidity and an acceptable complication rate when compared to a corrective osteotomy or an open Phemister-type epiphysiodesis. This study has led to our preference for the Canale method, which in our hands has fewer complications and is more successful at reaching the desired discrepancy correction.


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  1. Horton GA, Olney BW (1996) Epiphysiodesis of the lower extremity: results of the percutaneous technique. J Pediatr Orthop 16(2):180-182. doi:10.1097/00004694-199603000-00008
  2. Kemnitz S, Moens P, Fabry G (2003) Percutaneous epiphysiodesis for leg length discrepancy. J Pediatr Orthop B 12(1):69-71. doi:10.1097/00009957-200301000-00013
  3. Hasler CC (2000) Leg length inequality. Indications for treatment and importance of shortening procedures. Orthopade 29(9):766-774. doi:10.1007/s001320050525
  4. Nouth F, Kuo LA (2004) Percutaneous epiphysiodesis using transphyseal screws (PETS): prospective case study and review. J Pediatr Orthop 24(6):721-725. doi:10.1097/00004694-200411000-00023
  5. Surdam JW, Morris CD, DeWeese JD, Drvaric DM (2003) Leg length inequality and epiphysiodesis: review of 96 cases. J Pediatr Orthop 23(3):381-384. doi:10.1097/00004694-200305000-00020
  6. Ogilvie JW, King K (1990) Epiphysiodesis: two-year clinical results using a new technique. J Pediatr Orthop 10:809-811
  7. Khoury JG, Tavares JO, McConnell S, Zeiders G, Sanders JO (2007) Results of screw epiphysiodesis for the treatment of limb length discrepancy and angular deformity. J Pediatr Orthop 27:623-628
  8. Bowen JR, Johnson WJ (1984) Percutaneous epiphysiodesis. Clin Orthop 190:170-173
  9. Metaizeau JP, Wong-Chung J, Bertrand H, Pasquier P (1998) Percutaneous epiphysiodesis using transphyseal screws (PETS). J Pediatr Orthop 18(3):363-369. doi:10.1097/00004694-05000-00018
  10. Canale ST, Christian CA (1990) Techniques for epiphysiodesis about the knee. Clin Orthop 255:81-85
  11. Moseley CF (1977) A straight-line graph for leg-length discrepancies. J Bone Joint Surg Am 59(2):174-179
  12. Paley D, Bhave A, Herzenberg JE, Bowen JR (2000) Multiplier method for predicting limb-length discrepancy. J Bone Joint Surg Am 82(10):1432
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