Erdal Ozan A, Gorgun Baris, Razi Ozan, Sarikaya Ilker A, Inan Muharrem
Ortopediatri Istanbul, Academy of Pediatric Orthopaedics, Istanbul, Turkey.
Ministry of Health, Burhan Nalbantoglu State Hospital, Lefkosa, Cyprus.
J Child Orthop. 2022 Dec;16(6):505-511. doi: 10.1177/18632521221135192. Epub 2022 Nov 10.
One of the most common treatment methods for moderate limb length discrepancy in children is growth modulation using tension band plating. Coronal plane deformities after tension band plating for limb length discrepancy have been documented as an important complication in articles involving heterogeneous groups consisted of both idiopathic cases and patients with pathological physes. The aim of the study was to determine the rate of coronal plane deformities after treatment of a homogeneous group of idiopathic limb length discrepancy cases with tension band plating and to compare screw constructs of medial and lateral plates.
Patient files were retrospectively reviewed for amount of limb length discrepancy, anatomical femorotibial angle, mechanical lateral distal femoral angle, mechanical medial proximal tibial angle, and inter-screw angles of each plate on both sides of the tibiae and femora. Measurements at each follow-up period were compared to each other.
A total of 26 patient files (37 bones) were included to the study. The mean age was 10.5 years. The mean limb length discrepancy was 27.5 mm. Implants were removed after mean 34.5 months. The mean follow-up period was 58.5 months. There was no significant difference in inter-screw angle on each side of the bones at the time of implantation and in lower limb alignments during follow-up.
Treatment of mild-to-moderate idiopathic limb length discrepancy with tension band plating in children was found to be safe against any coronal plane deformity during follow-up until skeletal maturity.
Level IV.
儿童中度肢体长度不等最常见的治疗方法之一是使用张力带钢板进行生长调节。在涉及特发性病例和骨骺病变患者的异质性群体的文章中，肢体长度不等张力带钢板固定术后的冠状面畸形已被记录为一种重要并发症。本研究的目的是确定一组特发性肢体长度不等病例采用张力带钢板固定治疗后冠状面畸形的发生率，并比较内侧和外侧钢板的螺钉结构。
回顾性查阅患者病历，记录双侧胫骨和股骨的肢体长度不等量、解剖学股胫角、机械性外侧股骨远端角、机械性内侧胫骨近端角以及每块钢板的螺钉间角度。比较每次随访期间的测量值。
本研究共纳入26份患者病历（37块骨）。平均年龄为10.5岁。平均肢体长度不等为27.5mm。平均34.5个月后取出植入物。平均随访期为58.5个月。植入时骨两侧的螺钉间角度以及随访期间下肢对线情况无显著差异。
对于儿童轻度至中度特发性肢体长度不等，采用张力带钢板固定治疗在随访至骨骼成熟前对预防任何冠状面畸形是安全的。
四级。
