Vaishya Raju, Shah Malkesh, Agarwal Amit Kumar, Vijay Vipul
Department of Orthopaedic Surgery, Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi 110076, India.
J Clin Orthop Trauma. 2018 Oct-Dec;9(4):327-333. doi: 10.1016/j.jcot.2017.11.004. Epub 2017 Nov 14.
Genu valgum is an angular deformity of the knee, often treated surgically by osteotomy or by growth modulation (using tension band, staples, transphyseal screws and eight-plate which require removal after correction). With this study, we attempt to evaluate the efficacy, rate of correction and complications with the use of 8-plate in the correction of genu valgum deformity in children.
In a retrospective study of 24 patients with 11 bilateral and 13 unilateral (35 knees) genu valgum deformity which required surgical corrections were included. There were 11 males, and 13 females and all of them were treated with Steven's technique (Stevens, 2006) using eight-plate and monitored closely.
Twenty-four patients with an average age of 10 years and 8 months (range: 5 yrs, 7 months-14 yrs, 2 months), with the mean preoperative & post-implant removal (Post-IR) tibiofemoral angle of 22.02° ± 5.15° (range 14°-31°) & 6.14° ± 1.92° (range 2°-10°) respectively, required an average time period of 1yr & 5m ± 5 m (range 10 months-28 months) for correction after which implants were removed. Of the 35 limbs, we achieved excellent results in 91.6%. One case (4.16%) had a partial correction of the deformity, and one case (4.16%) had reported with a superficial infection which was taken care. There were 2 cases (8.33%) of over-correction, which was gradually self-corrected during follow-up.
Our results reflect the efficacy of flexible titanium eight plate which corrects angular deformity by acting as a tension band on one side of the growth plate and offers the advantage of reversible Hemi epiphyseal growth modulation. Guided growth modulation is a best available alternative for the treatment of an angular deformity in the patients with open physis.
膝外翻是膝关节的一种角状畸形，通常通过截骨术或生长调节（使用张力带、U形钉、经骺螺钉和八孔钢板，矫正后需要取出）进行手术治疗。在本研究中，我们试图评估使用八孔钢板矫正儿童膝外翻畸形的疗效、矫正率和并发症。
对24例需要手术矫正的膝外翻畸形患者进行回顾性研究，其中11例为双侧，13例为单侧（共35个膝关节）。患者中男性11例，女性13例，均采用史蒂文斯技术（史蒂文斯，2006年）使用八孔钢板治疗并密切监测。
24例患者平均年龄为10岁8个月（范围：5岁7个月至14岁2个月），术前及取出内固定物后（Post-IR）胫股角分别为22.02°±5.15°（范围14°至31°）和6.14°±1.92°（范围2°至10°），矫正平均需要1年5个月±5个月（范围10个月至28个月），之后取出内固定物。在35个肢体中，91.6%取得了优异的效果。1例（4.16%）畸形得到部分矫正，1例（4.16%）报告有浅表感染，已得到处理。有2例（8.33%）出现过度矫正，在随访期间逐渐自行矫正。
我们的结果反映了柔性钛制八孔钢板的疗效，它通过在生长板一侧作为张力带发挥作用来矫正角状畸形，并具有可逆性半骨骺生长调节的优势。引导性生长调节是治疗骨骺未闭患者角状畸形的最佳可用替代方法。
