Aeppli Tim R J, Benyi Emelie, Wehtje Henrik, Chrysis Dionisios, Sävendahl Lars
Pediatric Endocrinology Unit, Karolinska University Hospital, Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Horm Res Paediatr. 2025;98(2):185-192. doi: 10.1159/000538016. Epub 2024 Feb 23.
Treatment options in patients with extreme tall stature are limited. Bilateral epiphysiodesis has emerged as a possible treatment method aiming to reduce final height. However, there is still insufficient data on long-term safety and final height outcome. Therefore, the aim of this study was to assess the efficacy and safety of bilateral epiphysiodesis to reduce final adult height in tall adolescents.
The study population consisted of 72 patients with extreme tall stature who were followed at the Pediatric Endocrine Clinic at the Karolinska University Hospital, Stockholm (Sweden), and subsequently underwent bilateral epiphysiodesis around the knees (girls n = 45, boys n = 27).
When compared to the final height prediction at time of surgery, the procedure significantly reduced the achieved final height by a mean of 3.6 cm ± 0.4 cm in girls (p < 0.001; 26.0 ± 2.9% reduction) and 8.6 ± 0.9 cm in boys (p < 0.001; 40.5 ± 3.0% reduction). Furthermore, a negative correlation was observed between the absolute height reduction and the bone age at time of surgery, which was stronger in boys (r = -0.63, p < 0.001) than in girls (r = -0.44, p < 0.001). Besides reducing final height, body proportions were affected in all patients subjected to bilateral epiphysiodesis. However, as tall individuals typically have relatively long legs, body proportions were rather normalized after the surgery. There were no serious complications reported.
This study suggests that bilateral epiphysiodesis is an efficient and safe method to reduce final height in extremely tall adolescent girls and boys. The achieved height reduction was higher in boys and when performed at an earlier bone age. Importantly, no serious side effects were reported. However, a continued follow-up is still warranted to detect any potential rare complications.
Treatment options in patients with extreme tall stature are limited. Bilateral epiphysiodesis has emerged as a possible treatment method aiming to reduce final height. However, there is still insufficient data on long-term safety and final height outcome. Therefore, the aim of this study was to assess the efficacy and safety of bilateral epiphysiodesis to reduce final adult height in tall adolescents.
The study population consisted of 72 patients with extreme tall stature who were followed at the Pediatric Endocrine Clinic at the Karolinska University Hospital, Stockholm (Sweden), and subsequently underwent bilateral epiphysiodesis around the knees (girls n = 45, boys n = 27).
When compared to the final height prediction at time of surgery, the procedure significantly reduced the achieved final height by a mean of 3.6 cm ± 0.4 cm in girls (p < 0.001; 26.0 ± 2.9% reduction) and 8.6 ± 0.9 cm in boys (p < 0.001; 40.5 ± 3.0% reduction). Furthermore, a negative correlation was observed between the absolute height reduction and the bone age at time of surgery, which was stronger in boys (r = -0.63, p < 0.001) than in girls (r = -0.44, p < 0.001). Besides reducing final height, body proportions were affected in all patients subjected to bilateral epiphysiodesis. However, as tall individuals typically have relatively long legs, body proportions were rather normalized after the surgery. There were no serious complications reported.
This study suggests that bilateral epiphysiodesis is an efficient and safe method to reduce final height in extremely tall adolescent girls and boys. The achieved height reduction was higher in boys and when performed at an earlier bone age. Importantly, no serious side effects were reported. However, a continued follow-up is still warranted to detect any potential rare complications.
身材极高的患者的治疗选择有限。双侧骺骨干固定术已成为一种旨在降低最终身高的可能治疗方法。然而，关于长期安全性和最终身高结果的数据仍然不足。因此，本研究的目的是评估双侧骺骨干固定术在降低高个子青少年最终成人身高方面的疗效和安全性。
研究人群包括72例身材极高的患者，他们在瑞典斯德哥尔摩卡罗林斯卡大学医院的儿科内分泌诊所接受随访，随后在膝盖周围进行了双侧骺骨干固定术（女孩n = 45，男孩n = 27）。
与手术时的最终身高预测相比，该手术显著降低了女孩的最终身高，平均降低了3.6 cm±0.4 cm（p < 0.001；降低了26.0±2.9%）；男孩降低了8.6±0.9 cm（p < 0.001；降低了40.5±3.0%）。此外，观察到绝对身高降低与手术时的骨龄之间存在负相关，男孩（r = -0.63，p < 0.001）比女孩（r = -0.44，p < 0.001）的相关性更强。除了降低最终身高外，所有接受双侧骺骨干固定术的患者的身体比例都受到了影响。然而，由于高个子个体通常腿部相对较长，手术后身体比例相当程度上恢复了正常。没有严重并发症的报告。
本研究表明，双侧骺骨干固定术是一种有效且安全的方法，可降低身材极高的青少年女孩和男孩的最终身高。男孩以及在骨龄较小时进行手术时，实现的身高降低幅度更大。重要的是，没有报告严重的副作用。然而，仍有必要继续进行随访，以发现任何潜在的罕见并发症。
身材极高的患者的治疗选择有限。双侧骺骨干固定术已成为一种旨在降低最终身高的可能治疗方法。然而，关于长期安全性和最终身高结果的数据仍然不足。因此，本研究的目的是评估双侧骺骨干固定术在降低高个子青少年最终成人身高方面的疗效和安全性。
研究人群包括72例身材极高的患者，他们在瑞典斯德哥尔摩卡罗林斯卡大学医院的儿科内分泌诊所接受随访，随后在膝盖周围进行了双侧骺骨干固定术（女孩n = 45，男孩n = 27）。
与手术时的最终身高预测相比，该手术显著降低了女孩的最终身高，平均降低了3.6 cm±o.4 cm（p < 0.001；降低了26.0±2.�%）；男孩降低了8.6±0.9 cm（p < 0.001；降低了40.5±3.0%）。此外，观察到绝对身高降低与手术时的骨龄之间存在负相关，男孩（r = -0.63，p < 0.001）比女孩（r = -0.44，p < 0.001）的相关性更强。除了降低最终身高外，所有接受双侧骺骨干固定术的患者的身体比例都受到了影响。然而，由于高个子个体通常腿部相对较长，手术后身体比例相当程度上恢复了正常。没有严重并发症的报告。
本研究表明，双侧骺骨干固定术是一种有效且安全的方法，可降低身材极高的青少年女孩和男孩的最终身高。男孩以及在骨龄较小时进行手术时，实现的身高降低幅度更大。重要的是，没有报告严重的副作用。然而，仍有必要继续进行随访，以发现任何潜在的罕见并发症。
