Department of Paediatric Orthopaedics, King Faisal general Hospital, Hufuf, Saudi Arabia.
Division of Pediatric Orthopaedic Surgery, Department of Orthopaedic Surgery, Severance Children's Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
Sci Rep. 2024 Jun 18;14(1):14052. doi: 10.1038/s41598-024-64875-y.
Premature physeal arrest can cause progressive deformities and functional disabilities of the lower limbs. This study addressed the outcomes after physeal bar resection with or without guided growth (temporary hemiepiphysiodesis) for the treatment of angular limb deformities. We retrospectively analyzed 27 patients (mean 9 years; range, 3-12 years) who underwent physeal bar resection of the distal femur (15 patients), proximal tibia (3 patients), and distal tibia (9 patients) between 2002 and 2020. Fifteen patients underwent physeal bar resection only (Group A), and the other twelve underwent simultaneous guided growth (Group B). The correction angle (angle change between the preoperative and last follow-up values) was compared and analyzed. The overall mean correction angle was 2.9° (range, - 9 to 18.3°). A total of 12 (45%) patients had a > 5° angular deformity improvement (mean, 9.6°; range, 5-18.3°), 9 (33%) had a < 5° angular change; and 6 (22%) had a > 5° worsening of the angular deformity (mean, 6.7°; range, 5.2-9°). The correction angle in Group B (mean 7.6° ± 6.2) was significantly higher than that in Group A (mean - 0.77° ± 6.3) (P = 0.01). We found six (40%) and zero patients with a > 5° angular deformity increase in Groups A and B, respectively (P < 0.047). The group that underwent physeal bar resection with guided growth showed significantly higher correction angles than the group that underwent physeal bar resection alone. Additionally, none of the patients in the guided growth group experienced an increased angular deformity. Therefore, combining guided growth with physeal bar resection may lead to better outcomes in the treatment of growth arrest with angular deformities.
骺板早闭可导致下肢进行性畸形和功能障碍。本研究探讨了切除骺板后是否结合生长引导（临时骺板骺融合术）治疗成角性肢体畸形的疗效。我们回顾性分析了 2002 年至 2020 年间接受远端股骨（15 例）、近端胫骨（3 例）和远端胫骨（9 例）骺板切除术的 27 例患者（平均 9 岁；范围，3-12 岁）。15 例患者仅行骺板切除术（A 组），其余 12 例患者同期行生长引导（B 组）。比较并分析了矫正角度（术前与末次随访时的角度变化）。总的平均矫正角度为 2.9°（范围，-9 至 18.3°）。12 例（45%）患者成角畸形改善>5°（平均 9.6°；范围，5-18.3°），9 例（33%）患者成角变化<5°，6 例（22%）患者成角畸形恶化>5°（平均 6.7°；范围，5.2-9°）。B 组（平均 7.6°±6.2）的矫正角度明显高于 A 组（平均-0.77°±6.3）（P=0.01）。A 组和 B 组分别有 6 例（40%）和 0 例患者成角畸形增加>5°（P<0.047）。行骺板切除结合生长引导的患者矫正角度明显高于仅行骺板切除的患者。此外，生长引导组无患者出现成角畸形增加。因此，在治疗成角性生长停滞时，骺板切除结合生长引导可能会取得更好的效果。
