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  • Title: Angular deformity correction by guided growth in growing children: Eight-plate versus 3.5-mm reconstruction plate.
    Author: Park KH, Oh CW, Kim JW, Park IH, Kim HJ, Choi YS.
    Journal: J Orthop Sci; 2017 Sep; 22(5):919-923. PubMed ID: 28688811.
    Abstract:
    BACKGROUND: Guided growth using the eight-plate (8-plate) is the most commonly used method to correct angular deformities in children; however, implant failure has been reported. Recently, the 3.5-mm reconstruction plate (R-plate) has been used as an alternative option for guided growth; however, hardware prominence has been problematic. This study aimed to compare the coronal angular deformity correction results of guided growth between relatively thin 8-plates with cannulated screws and thick R-plates with solid screws. METHODS: Thirty-nine physes (24 distal femoral, 15 proximal tibial) in 20 patients underwent hemiepiphysiodesis using 8-plates, and 61 physes (40 distal femoral, 21 proximal tibial) in 35 patients underwent hemiepiphysiodesis using R-plates. Coronal angular corrections were measured and compared preoperatively, and after the completion of corrections. Amounts and rates of correction and complications were compared between the groups. RESULTS: Mean body mass index was 18.7 kg/m2 in the 8-plate group, and 22.7 kg/m2 in the R-plate group. Angular correction was achieved in all deformities at a mean of 13.7 months and 19.7 months in the 8-plate and the R-plate group, respectively. The mean corrected mechanical lateral distal femoral angle was 9.0° in the 8-plate group, and 9.9° in the R-plate group (P = 0.55). The mean corrected medial proximal tibial angle was 7.1° in the 8-plate group, and 9.0° in the R-plate group (P = 0.07). The mean rates of angular correction were also not significantly different in the distal femur (1.03°/month vs. 0.77°/month, P = 0.2) and the proximal tibia (0.66°/month vs. 0.63°/month, P = 0.77). There was one superficial infection in each group, and one case of implant failure in the R-plate group. Two rebound deformities were observed and needed repeat hemiepiphysiodesis. Permanent physeal arrest was not observed in this series.
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