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

Background: High cost of eight-plate makes it unavailable in many countries; therefore, developing an alternativedevice for temporary hemiepiphysiodesis of knee deformities in pediatrics is valuable. In this study, we compared theoutcome of the eight-plate with the reconstruction-plate in this setting.Methods: In this retrospective study, ۱۰۹ skeletally immature patients (۲۱۲ physes) who underwent temporaryhemiepiphysiodesis to correct idiopathic genu valgum were included. The eight-plate and reconstruction-plate wereused in ۴۵ patients (۹۰ physes) and ۶۲ patients (۱۲۲ 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 meanfollow-up of the patients was ۳۲.۹ ± ۱۵.۱ months. The mean MPTA change was ۲.۷ ± ۳.۷º in the eight-plate groupand ۲.۱ ± ۳.۴º in the reconstruction-plate group (P=۰.۲). The mean LDFA improvement was ۸ ± ۳.۷º in the eight-plategroup and ۷.۹ ± ۳.۵º in the reconstruction-plate group (P=۰.۶۱). The mean valgus correction was ۱۰.۷ ± ۴.۴º in theeight-plate group and ۱۰.۴ ± ۴.۶º in the reconstruction-plate group (P=۰.۷۴). Moreover, the mean change of JLCA was۰.۷ ± ۱.۳º in the eight-plate group and ۰.۸ ± ۱.۳º in the reconstruction-plate group (P=۰.۵۸). The postoperative LLMAwas comparable between the two study groups as well. In total, five postoperative complications were recorded inthis series, which included one case of screw loosening in each group, two cases of overcorrection, and one screwbreakage 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

Keywords:

eight-plate , Hemiepiphysiodesis , idiopathic genu valgum , Reconstruction-plate , Pediatrics