Sanpera Ignacio, Raluy-Collado David, Frontera-Juan Guillem, Tejada-Gavela Silvia, Ramos-Asensio Rafael
Pediatric Orthopaedic Department, Hospital Universitari Son Espases, Palma de Mallorca, Spain.
J Pediatr Orthop. 2012 Dec;32(8):815-20. doi: 10.1097/BPO.0b013e31824b755a.
During the last few years, the use of the 8-plate as a technique for hemiepiphysiodesis has gained wide acceptance, as it has been shown that it works in a more physiological way than other methods such as staples or transphyseal screws. It has mechanically been compared with a tension band plate, and for this reason, only a single plate is needed. The following study was undertaken to test the 8-plate against the staples and assess factors that can influence the difference in results.
A prospective experimental study was designed to compare the ability of 2 hemiepiphysiodesis methods, the 8-plate and the double staple, to produce angular deformity in the rabbit's tibia (group I). The variable studied was the variations in the articular line-diaphysis angle at 6 weeks. As the results showed that the 8-plate produced a bigger deformity, a second group was designed (group II) comparing single against double staple, under the hypothesis that the differences observed in the first group could be related to the number of anchors put across the physis and consequently depend on the volume of physis involved by the staples.
In group I, the 8-plate produced a bigger angulation at 6 weeks' time than the 2 staples (a difference of 6.5 degrees, P = 0.03). Similarly, in group II, the single staple produced a greater angulation than the 2 staples (difference 6 degrees, P = 0.08). When both groups were compared, no differences in the angulation produced by the 8-plate and the single staple with respect to the 2 staples were found.
These results suggest that one of the reasons why the 8-plate may act in a more "physiological way" (vs. the traditional 2-staple or 3-staple hemiepiphysiodesis) could be the fact that the growth plate is tethered only at a single point. Therefore, the physis retains a major potential for growth and deformity.
The 8-plate is superior in producing/correcting angular deformity when compared with the traditionally used staples (2 or more) but not when compared with a single staple.
在过去几年中，8字钢板作为一种半骨骺阻滞技术已被广泛接受，因为研究表明，它比其他方法（如骑缝钉或经骨骺螺钉）的作用方式更为生理。从力学角度将其与张力带钢板进行了比较，因此仅需一块钢板。进行以下研究以对比8字钢板和骑缝钉，并评估可能影响结果差异的因素。
设计一项前瞻性实验研究，比较两种半骨骺阻滞方法（8字钢板和双骑缝钉）使兔胫骨产生角形畸形的能力（第一组）。研究变量为6周时关节线-骨干角的变化。由于结果显示8字钢板产生的畸形更大，于是设计了第二组（第二组），比较单骑缝钉和双骑缝钉，基于的假设是第一组中观察到的差异可能与穿过骨骺的锚钉数量有关，因此取决于骑缝钉涉及的骨骺体积。
在第一组中，8字钢板在6周时产生的成角比两枚骑缝钉更大（相差6.5度，P = 0.03）。同样，在第二组中，单枚骑缝钉产生的成角比两枚骑缝钉更大（相差6度，P = 0.08）。比较两组时，未发现8字钢板和单枚骑缝钉相对于两枚骑缝钉产生的成角有差异。
这些结果表明，8字钢板可能以更“生理的方式”起作用（与传统的双枚或三枚骑缝钉半骨骺阻滞相比）的原因之一可能是生长板仅在单个点受到束缚。因此，骨骺保留了主要的生长和畸形潜能。
与传统使用的两枚（或更多）骑缝钉相比，8字钢板在产生/矫正角形畸形方面更具优势，但与单枚骑缝钉相比则不然。
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