Gaumétou Elodie, Mallet Cindy, Souchet Philippe, Mazda Keyvan, Ilharreborde Brice
Department of Pediatric Orthopaedics, Robert Debré Hospital, Paris Diderot University, Paris, France.
J Pediatr Orthop. 2016 Oct-Nov;36(7):715-9. doi: 10.1097/BPO.0000000000000518.
Among the numerous existing epiphysiodesis procedures, the eight-plate-guided growth technique, initially described for angular deformities correction, has progressively gained popularity among pediatric orthopaedic surgeons to treat lower limb discrepancy (LLD). The goal of this study was to assess the efficacy of eight-plates in LLD.
All children treated for LLD with eight-plates were prospectively included and followed until skeletal maturity. Efficacy of the epiphysiodesis was calculated 6 and 18 months postoperatively and at latest follow-up, according to a method previously validated for percutaneous epiphysiodesis using transphyseal screws (PETS). Radiologic measurements were performed using 3-dimensional low-dose stereoradiography. Intraoperative and postoperative complications were reported.
Thirty-two patients were included (average age at surgery, 12.5 y). For femoral epiphysiodesis, efficacy was only 23% at 6 months and 68% at latest follow-up. The procedure was even less efficient on the proximal tibia, with only 42% of the expected growth arrest at latest examination. Eight patients (20%) experienced plate-related pain during follow-up, and 5 physes (12.5%) required unplanned revision surgery.
Results of the current series show that the eight-plate technique procedure was associated with few perioperative complications, but the growth arrest observed at follow-up was unpredictable and lower than that achieved with PETS in previous reports. Eight-plate procedures cannot be considered as an efficient epiphysiodesis technique in comparison with standard technique.
Level IV.
在众多现有的骨骺阻滞手术中，最初用于矫正角状畸形的八板引导生长技术，在小儿骨科医生中越来越受欢迎，用于治疗下肢不等长（LLD）。本研究的目的是评估八板技术治疗LLD的疗效。
所有接受八板技术治疗LLD的儿童均被前瞻性纳入并随访至骨骼成熟。根据先前验证的经皮骨骺阻滞使用经骨骺螺钉（PETS）的方法，在术后6个月、18个月以及最后一次随访时计算骨骺阻滞的疗效。使用三维低剂量立体放射摄影进行放射学测量。报告术中及术后并发症。
纳入32例患者（手术平均年龄12.5岁）。对于股骨骨骺阻滞，6个月时的疗效仅为23%，最后一次随访时为68%。该手术在胫骨近端的效果更差，在最后一次检查时预期生长阻滞仅为42%。8例患者（20%）在随访期间出现与钢板相关的疼痛，5个骨骺（12.5%）需要进行计划外的翻修手术。
本系列结果表明，八板技术手术围手术期并发症较少，但随访时观察到的生长阻滞不可预测，且低于先前报道中PETS所达到的水平。与标准技术相比，八板技术不能被认为是一种有效的骨骺阻滞技术。
IV级。
