八孔钢板与重建钢板在儿童特发性膝外翻临时半骨骺阻滞术中的比较

Comparison of Eight-plate with Reconstruction-plate in Temporary Hemiepiphysiodesis ‎to Correct the Idiopathic Genu Valgum ‎in Pediatrics.

作者信息

Ghaznavi Alireza, Baghdadi Taghi, Bagherifard Abolfazl, Fakoor Sajad, Shirvani Saeid, Sadat Kiaei Seyed Matin, Mohammadpour Mehdi

机构信息

Bone and Joint Reconstruction Research Center, Department of Orthopedics, School of medicine, Iran University of Medical Sciences, Tehran, Iran.

Joint Reconstruction Research Center, Department of Orthopedics, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Bone Jt Surg. 2022 Jul;10(7):585-591. doi: 10.22038/ABJS.2022.60663.2990.

DOI:10.22038/ABJS.2022.60663.2990

PMID:36032638

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9382255/

Abstract

BACKGROUND

High cost of eight-plate makes it unavailable in many countries; therefore, ‎developing an ‎alternative device for temporary hemiepiphysiodesis of knee deformities in ‎pediatrics ‎is valuable. In this study, we compared the outcome of the eight-plate with the ‎reconstruction-plate in this setting.

METHODS

In this retrospective study, 109 skeletally immature patients (212 physes) who underwent temporary hemiepiphysiodesis to correct idiopathic genu valgum were included. The eight-plate and reconstruction-plate were used in 47 patients (90 physes) and 62 patients (122 physes), respectively. Outcome measures were the valgus angle, medial proximal tibial angle (MPTA), the lateral distal femoral angle (LDFA), the joint-line convergence angle (JLCA), and lower limb mechanical axis (LLMA).

RESULTS

The baseline characteristics of the patients were comparable between the two plate groups. The mean follow-up of the patients was 32.9 ± 15.1 months. The mean MPTA change was 2.7 ± 3.7º in the eight-plate group and 2.1 ± 3.4º in the reconstruction-plate group (). The mean LDFA improvement was 8 ± 3.7º in the eight-plate group and 7.9 ± 3.5º in the reconstruction-plate group (=0.61). The mean valgus correction was 10.7 ± 4.4º in the eight-plate group and 10.4 ± 4.6º in the reconstruction-plate group (). Moreover, the mean change of JLCA was 0.7 ± 1.3º in the eight-plate group and 0.8 ± 1.3º in the reconstruction-plate group (). The postoperative LLMA was comparable between the two study groups as well. In total, five postoperative complications were recorded in this series, which included one case of ‎screw loosening in each group, two cases of overcorrection, and one screw breakage in the ‎reconstruction-plate group.

CONCLUSION

The radiologic results and complications of the reconstruction-plate are comparable with the eight-plate. Therefore, it can be safely and efficiently used in hemiepiphysiodesis to correct idiopathic genu valgum.

摘要

背景

八孔钢板成本高昂，许多国家无法使用；因此，开发一种用于小儿膝关节畸形临时半骨骺阻滞的替代装置具有重要价值。在本研究中，我们比较了八孔钢板与重建钢板在这种情况下的治疗效果。

方法

在这项回顾性研究中，纳入了109例骨骼未成熟患者（212个骨骺），他们接受了临时半骨骺阻滞以纠正特发性膝外翻。八孔钢板组和重建钢板组分别有47例患者（90个骨骺）和62例患者（122个骨骺）。观察指标包括外翻角、胫骨近端内侧角（MPTA）、股骨远端外侧角（LDFA）、关节线汇聚角（JLCA）和下肢机械轴（LLMA）。

结果

两组患者的基线特征具有可比性。患者的平均随访时间为32.9±15.1个月。八孔钢板组的平均MPTA变化为2.7±3.7°，重建钢板组为2.1±3.4°（）。八孔钢板组的平均LDFA改善为8±3.7°，重建钢板组为7.9±3.5°（=0.61）。八孔钢板组的平均外翻矫正为10.7±4.4°，重建钢板组为10.4±4.6°（）。此外，八孔钢板组的平均JLCA变化为0.7±1.3°，重建钢板组为0.8±1.3°（）。两个研究组术后的LLMA也具有可比性。本系列共记录了5例术后并发症，包括每组1例螺钉松动、2例过度矫正以及重建钢板组1例螺钉断裂。