Background: Hemiepiphysiodesis is a well-established treatment option for angular deformities of the knee. Recently, our institution began using the eight-Plate tension band device by Orthofix (McKinney, Tex) as an alternative to staples. However, several patients have returned with broken screws necessitating revision surgery.
Methods: Charts and radiographs of all patients who were treated with the eight-Plate (Orthofix) at our institution were reviewed. The diagnosis, age, amount of angular deformity, weight, and body mass index were analyzed with respect to eventual implant failure.
Results: Implant failure occurred in 8 (26%) of 31 proximal tibia constructs. All 8 failures occurred in patients with Blount disease and involved breakage of the tibial metaphyseal screw. The mean time to failure was 13.6 months. Eight hardware failures in 18 Blount disease extremities represent a failure rate of 44%. No implant failures occurred in the remaining diagnoses. Neither age nor degree of deformity correlated with implant failure. The failure group was significantly heavier than the nonfailure group, and the patients with Blount disease were found to be heavier than the other patients. However, no significant difference in weight was found within the Blount group regarding implant failure. In all patients whose plates did not fail, rate of correction was equal to or better than previously reported hemiepiphysiodesis studies.
Conclusions: The eight-Plate (Orthofix) is a reasonable option for hemiepiphysiodesis but has an unacceptable failure rate in Blount disease (44%). There were no instances of failure in patients with other diagnoses. In Blount disease, stronger implants should be considered. Future implant designs should include stronger screws to decrease implant failure complications.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/BPO.0b013e3181919b54 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Medial Tibial Condylar Valgus Osteotomy improve clinical outcomes and effectively corrects significant Tibial varus deformities without compromising joint line obliquity or patellar heigh.
Orthop Traumatol Surg Res
October 2024
Institut du Mouvement et de l'appareil Locomoteur, Hôpital Sainte-Marguerite, Aix-Marseille Université, Marseille, France. Electronic address:
Background: Tibial condylar valgus osteotomy (TCVO), or Chiba osteotomy, is a recognized procedure for treating advanced knee osteoarthritis in middle-aged individuals. Although its effectiveness is established, limited literature exists on its outcomes for specific conditions such as post-traumatic deformities, Blount disease (BD), and Pagoda-like proximal tibia varus deformities.
Hypothesis: We hypothesized that TCVO could improve both clinical and radiographic outcomes in patients with severe varus deformities, correcting lower-limb variances while preserving joint line obliquity (JLO) and patellar height in substantial varus deformities.
Success of topiramate to slow progression of Blount disease in a toddler: A case study.
Radiol Case Rep
November 2024
Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Rates of Blount disease and childhood obesity have increased in parallel, although the co-management of this acquired comorbidity and obesity is not well described. This report shares the course of a toddler with severe obesity who experienced rapid and persistent weight gain without success from nutrition and behavior changes. After repeat subspeciality evaluation, the patient was ultimately diagnosed with signs of early-onset Blount disease, urging the need for adjunct medical therapy.
View Article and Find Full Text PDFChiba osteotomy (Tibial condylar valgus osteotomy) for a large tibial varus deformity: Technical note.
Orthop Traumatol Surg Res
August 2024
London Knee Osteotomy Centre, Orthopaedic Specialists, Harley Street Specialist Hospital, London, United Kingdom.
Chiba osteotomy is an effective technique for advanced knee osteoarthritis (KOA). The principle of the osteotomy is to correct both varus deformity and intra-articular joint congruity through an L-shaped osteotomy from the medial tibial condyle to the lateral intercondylar eminence. Previous studies have demonstrated that Chiba osteotomy is an effective method for alignment correction surgery for severe knee osteoarthritis.
View Article and Find Full Text PDFSevere complex neglected infantile Blount disease acute correction by Ilizarov frame: A case report.
Int J Surg Case Rep
August 2024
Pediatric Sub-Division, Orthopaedic and Traumatology Division, Department of Surgery, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Yogyakarta, Indonesia; Orthopaedic and Traumatology Division, Department of Surgery, Dr. Sardjito General Hospital, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Yogyakarta, Indonesia. Electronic address:
Article Synopsis
- Blount disease causes deformities in the knees, including bowing and misalignment, and its treatment remains debated despite various approaches.
- A case of a nine-year-old girl with significant knee deformities was successfully treated using the Ilizarov external fixator, resulting in noticeable clinical improvement.
- The Ilizarov frame is recommended for its ability to provide precise corrections while minimizing risks compared to alternative techniques like physeal distraction, leading to positive treatment outcomes without significant complications.
Pediatric hypophosphatasia: avoid diagnosis missteps!
J Bone Miner Res
July 2024
Center for Metabolic Bone Disease and Molecular Research, Shriners Hospitals for Children-St. Louis; St. Louis, MO 63110, United States.
Article Synopsis
- Hypophosphatasia (HPP) is a genetic disorder that affects bones and teeth because a specific gene called ALPL doesn’t work right.
- When ALPL is mutated, it leads to a buildup of substances that can weaken bones and teeth, causing issues like weak muscles.
- Diagnosing HPP can be tricky because it has different forms and symptoms, but testing the ALPL gene and using special treatments can help manage it better.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!