Epiphyseal stimulation in the lower extremities.

Epiphyseal stimulation to correct disparity in the length of lower extremities was done in 12 children. The total number of procedures was 15. In 11 of the 15 instances the operation was beneficial. Ivory pegs were used in some cases, brass screws in others and multiple drill holes in still others. There seemed to be no difference between them in the amount of stimulation brought about. Stimulation persisted for from six to ten months after operation. Complications that may occur are varus or valgus deformities, delay in growth, complete fusion, or infection. To prevent varus or valgus deformity, both medial and lateral sides may be stimulated simultaneously. Great care must be taken to place the screws no closer than one-fourth inch to the epiphyseal plate to avoid trauma which may delay rather than stimulate growth. Late infection may be obviated by the use of absorbable materials. The increase brought about by stimulation procedures is probably attributable to hyperemia following subperiosteal stripping.