Pediatric Orthopedics, Hadassah - Hebrew University Medical Center, Jerusalem, Israel.
Pediatric Orthopedics, Ruth Rappoport Children's Hospital, Rambam Health Care Campus, 8 Haaliya Hashniya Street, 3525408, Haifa, Israel.
Eur J Orthop Surg Traumatol. 2023 May;33(4):837-842. doi: 10.1007/s00590-022-03217-y. Epub 2022 Feb 4.
Coronal plane deformities around the knee are rather common condition in children. Guided growth by temporary hemiepiphysiodesis is considered to be the preferred primary treatment in many cases. Despite the popularity of hemiepiphysiodesis, the incidence of recurrence of deformity and predictors for rebound are not well defined. The objectives of this study were to determine the incidence of the recurrence of varus-valgus deformities around the knee treated by temporary hemiepiphysiodesis and possible predictors for the rebound.
We retrospectively reviewed medical records and x-ray images of 130 patients with varus-valgus deformities around the knee treated by tension-band (eight-plate) hemiepiphysiodesis, between the years 2006 and 2016 in our institution. The incidence of rebound of varus-valgus deformities around the knee and possible predictors were analyzed.
Rebound of the deformity was observed in 10% of patients. Risk factors found to be in correlation with recurrence include young age, deformity of proximal tibia, proximal tibial medial growth plate beaking, and comorbidities (like metabolic disorders, multiple hereditary exostoses and genetic syndromes).
The results of this study show that there is a noteworthy incidence of rebound in patients treated by temporary hemiepiphysiodesis for coronal deformities around the knee. The risk factors are also outlined. These patients, especially the ones with risk factors, require close surveillance until maturity.
Level III-Case control study.
膝关节周围冠状面畸形在儿童中较为常见。在许多情况下，临时骺板切除术引导生长被认为是首选的主要治疗方法。尽管骺板切除术很流行，但畸形复发的发生率和反弹的预测因素尚未得到很好的定义。本研究的目的是确定膝关节周围临时骺板切除术治疗的内翻-外翻畸形的复发发生率和反弹的可能预测因素。
我们回顾性分析了 2006 年至 2016 年间我院采用张力带（八板）骺板切除术治疗的 130 例膝关节周围内翻-外翻畸形患者的病历和 X 线图像。分析了膝关节周围内翻-外翻畸形反弹的发生率和可能的预测因素。
10%的患者出现畸形反弹。与复发相关的危险因素包括年龄较小、胫骨近端畸形、胫骨近端内侧骺板骨突、合并症（如代谢紊乱、多发性遗传性外生骨疣和遗传综合征）。
本研究结果表明，膝关节周围冠状面畸形采用临时骺板切除术治疗后，存在明显的反弹发生率。还概述了风险因素。这些患者，尤其是有危险因素的患者，需要密切监测至成熟。
III 级-病例对照研究。
