Department of Pediatrics, Catharina Hospital, Eindhoven, The Netherlands.
Orthopaedic Centre Máxima, Máxima Medical Centre, Eindhoven, The Netherlands.
Arch Dis Child. 2018 Mar;103(3):219-223. doi: 10.1136/archdischild-2017-313295. Epub 2017 Oct 13.
Percutaneous epiphysiodesis (PE) around the knee to reduce predicted excessive final height. Studies until now included small numbers of patients and short follow-up periods.
This Dutch multicentre, long-term, retrospective, follow-up study aimed to assess adult height (AH), complications, knee function and patient satisfaction after PE. The primary hypothesis was that PE around the knee in constitutionally tall boys and girls is an effective treatment for reducing final height with low complication rates and a high level of patient satisfaction.
77 treated adolescents and 60 comparisons.
Percutaneous epiphysiodesis.
AH, complications, knee function, satisfaction.
In the PE-treated group, final height was 7.0 cm (±6.3 cm) lower than predicted in boys and 5.9 cm (±3.7 cm) lower than predicted in girls. Short-term complications in file search were seen in 5.1% (three infections, one temporary nerve injury), one requiring reoperation. Long-term complications in file search were seen in 2.6% (axis deformity 1.3%, prominent head of fibula 1.3%). No significant difference in knee function was found between treated cases and comparisons. Satisfaction was high in both the comparison and PE groups; most patients in the PE group recommended PE as the treatment for close relatives with tall stature.
PE is safe and effective in children with predicted excessive AH. There was no difference in patient satisfaction between the PE and comparison group. Careful and detailed counselling is needed before embarking on treatment.
膝关节周围经皮骺阻滞术（PE）可减少预测的过高终身高。迄今为止的研究纳入的患者数量较少，随访时间较短。
本项荷兰多中心、长期、回顾性随访研究旨在评估 PE 治疗后患者的终身高（AH）、并发症、膝关节功能和患者满意度。主要假设是膝关节周围 PE 治疗身材高大的男孩和女孩是一种有效减少最终身高的治疗方法，其并发症发生率低，患者满意度高。
77 名接受治疗的青少年和 60 名对照者。
经皮骺阻滞术。
在接受 PE 治疗的患者中，男孩的实际终身高比预测终身高低 7.0cm（±6.3cm），女孩的实际终身高比预测终身高低 5.9cm（±3.7cm）。在文件检索中，短期并发症为 5.1%（3 例感染，1 例暂时性神经损伤），其中 1 例需要再次手术。在文件检索中，长期并发症为 2.6%（轴畸形 1.3%，腓骨头突出 1.3%）。治疗组与对照组之间的膝关节功能无显著差异。两组患者的满意度均较高；PE 组的大多数患者建议将 PE 作为治疗身材高大的近亲的方法。
PE 治疗预测 AH 过高的儿童是安全有效的。PE 组和对照组患者的满意度无差异。在开始治疗前需要进行仔细和详细的咨询。
