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Häufigkeit und Prädiktoren für einen Rebound nach operativer Achskorrektur in der Frontalebene

Eine Literaturübersicht

Prevalence and predictors of rebound deformity in the frontal plane

A literature review

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Zusammenfassung

Diese Literaturübersicht stellt den aktuellen Kenntnisstand über Häufigkeit und Ursachen eines Rebounds nach zunächst erfolgreicher Korrektur der Beinachsendeformität mittels temporärer Hemiepiphysiodese bei Kindern und Jugendlichen dar. Insgesamt konnten 20 Studien durch drei unabhängige Gutachter eingeschlossen werden. Die Aussagekraft der meisten Studien zur Rebound-Rate ist limitiert durch einen nichtstandardisierten Nachbeobachtungszeitraum nach Metallentfernung, heterogene Patientengruppen mit geringer Fallzahl und fehlende Angaben zur Definition eines Rebounds. Die Rebound-Quote bei Studien ohne elementare Limitationen beim Studiendesign beträgt im Mittel ca. 50 % und unterstreicht die klinische Relevanz der Thematik. Lediglich vier Studien geben Gründe oder Risikofaktoren für das Auftreten eines Rebounds an. Vor allem ein junges Alter bei Behandlungsbeginn mit hohem Restwachstumspotenzial nach Metallentfernung stellt ein erhöhtes Risiko für einen Rebound dar, welches durch eine entsprechende Überkorrektur der Beinachse minimiert werden kann.

Abstract

The present literature review presents the current state of the art on the prevalence and causes of the rebound phenomenon after successful correction of leg axis deformity using temporary epiphysiodesis in children and adolescents. A total of 20 studies was included by three independent reviewers. The validity of most studies regarding the rebound incidence is limited by a non-standardized follow-up after plate removal, heterogeneous patient groups with a small number of cases, and missing information on the definition of rebound. The rebound incidence in studies without fundamental limitations in study design is on an average about 50% and underlines the clinical relevance of the topic. Only four studies reported reasons or risk factors for the occurrence of a rebound. In particular, a young age at the beginning of treatment with high residual growth potential after implant removal represents an increased rebound risk, which can be minimized by appropriate overcorrection of the leg axis.

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Abb. 1

Abbreviations

aLDFW:

Anatomischer lateraler distaler Femurwinkel

aMPTW :

Anatomischer medialer proximaler Tibiawinkel

B :

Beine

BMI :

Body-Mass-Index

MAD :

Mechanische Achsabweichung (Mikulicz-Linie)

ME :

Metallentfernung

mFTW :

Mechanischer femorotibialer Winkel

mLDFW :

Mechanischer lateraler distaler Femurwinkel

mMPTW :

Mechanischer medialer proximaler Tibiawinkel

P :

Patienten*innen

SD :

Standardabweichung

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Danksagung

Dieser Beitrag ist im Rahmen eines von der Deutschen Forschungsgemeinschaft (DFG) geförderten Projekts entstanden (Projektnummer: 403837822).

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Authors and Affiliations

  1. Klinik für Orthopädie (Friedrichsheim), Universitätsklinikum Frankfurt, Marienburgstraße 2, 60528, Frankfurt am Main, Deutschland

    Felix Stief, Jana Holder & Andrea Meurer

  2. Orthopädische Kinderklinik, Aschau im Chiemgau, Deutschland

    Harald Böhm

  3. PFH Private Hochschule, Göttingen, Deutschland

    Harald Böhm

Authors
  1. Felix Stief
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  2. Jana Holder
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  4. Andrea Meurer
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Correspondence to Felix Stief.

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Interessenkonflikt

F. Stief, J. Holder, H. Böhm und A. Meurer geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Stief, F., Holder, J., Böhm, H. et al. Häufigkeit und Prädiktoren für einen Rebound nach operativer Achskorrektur in der Frontalebene. Orthopäde 50, 548–558 (2021). https://doi.org/10.1007/s00132-021-04118-4

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  • DOI: https://doi.org/10.1007/s00132-021-04118-4

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