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Temporary Epiphysiodesis Using the Eight-Plate in the Management of Children with Leg Length Discrepancy: A Retrospective Case Series

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Abstract

Background

Although eight-plates have been shown to be effective in correcting angular deformities of the knee, the literature is scarce regarding the efficiency of this method in treatment of children with LLD.

Objectives

The aim of this study was to determine the efficiency, rates of correction and complications of epiphysiodesis using eight-plate in the management of children with leg length discrepancy (LLD).

Methods

Eleven consecutive patients with LLD (7 boys, median age = 9, age range 6–11 years) who were treated by temporary epiphysiodesis using eight-plates were retrospectively reviewed and included in the study. The main indication for temporary epiphysiodesis was an LLD between 2 and 5 cm in all patients. LLD and lower limb alignment were examined on lower extremity weight-bearing radiography preoperatively and at skeletal maturity. Longitudinal correction rate was calculated. The final LLD was categorized as ‘’good result’’ (final LLD < 1.5 cm), ‘’fair result’’ (1.5–2 cm), and ‘’poor result’’ (> 2 cm).

Results

The mean treatment period with the eight-plate was 44 (min to max = 32–72) months, and the mean follow-up from the index surgery to the final follow-up was 62 (min to max = 39–106) months. The mean LLD was significantly reduced from 39 (range 25–50) mm preoperatively to 22.40 (range 6–55) mm postoperatively (p = 0.006). The mean longitudinal correction rate was found to be 0.48 mm/mo. Radiographic evidence of lower limb deformity in frontal and sagittal planes was determined in neither preoperative nor postoperative deformity analysis. No major complications were recorded.

Conclusion

For the management of children with LLD of 2–5 cm, temporary hemiepiphysiodesis using the eight-plate seems to be an effective treatment with low complication rates.

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Authors and Affiliations

  1. Istanbul Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul University, Çapa Fatih, 34050, Istanbul, Turkey

    Mehmet Demirel, Yavuz Sağlam, Ahmet M. Yıldırım, Fuat Bilgili & Cengiz Şen

  2. School of Medicine, Department of Orthopedics and Traumatology, Istanbul University-Cerrahpaşa, Cerrahpaşa Fatih, 34098, Istanbul, Turkey

    Ali Şeker

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  1. Mehmet Demirel
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  2. Yavuz Sağlam
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  4. Fuat Bilgili
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  6. Cengiz Şen
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Contributions

Each author listed above contributed significantly to, and is willing to take public responsibility for, one or more aspects of the study. All authors participated in the study design and analysis and interpretation of the data. All authors were actively involved in drafting and the critical revision of the manuscript and have given final approval of the version to be submitted. YS: design of the study, analysis and interpretation of data, drafting and critical revision of the manuscript. MD: analysis of data, drafting and critical revision of the manuscript. MAY: design of the study, drafting and critical revision of the manuscript. FB: design of the study, drafting and critical revision of the manuscript. AŞ: drafting and critical revision of the manuscript. CS: design of the study, drafting and critical revision of the manuscript.

Corresponding author

Correspondence to Mehmet Demirel.

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Conflict of Interest

Mehmet Demirel, Yavuz Sağlam, Ahmet M. Yıldırım, Fuat Bilgili, Ali Şeker, and Cengiz Şen declare that they have no conflict of interest. Each author certifies that he or she has no commercial associations that might pose a conflict of interest in connection with the submitted article.

Ethical Approval

Approval of the institutional board review of the current study was obtained from the Istanbul University, Istanbul Faculty of Medicine in 10. 05. 2019. The study was performed in accordance with the ethical standards in the 1964 Declaration of Helsinki. All the study was performed at İstanbul University, İstanbul Faculty of Medicine.

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This study has not been published elsewhere before. It is not accepted for publication and under consideration by another publication.

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Demirel, M., Sağlam, Y., Yıldırım, A.M. et al. Temporary Epiphysiodesis Using the Eight-Plate in the Management of Children with Leg Length Discrepancy: A Retrospective Case Series. JOIO 56, 874–882 (2022). https://doi.org/10.1007/s43465-021-00599-9

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  • DOI: https://doi.org/10.1007/s43465-021-00599-9

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