Starobrat Grzegorz, Danielewicz Anna, Szponder Tomasz, Wójciak Magdalena, Sowa Ireneusz, Różańska-Boczula Monika, Latalski Michał
Department of Paediatric Orthopaedics, Medical University of Lublin, 20-059 Lublin, Poland.
Department and Clinic of Animal Surgery, Faculty of Veterinary Medicine, University of Life Sciences, 20-612 Lublin, Poland.
J Clin Med. 2025 Jan 4;14(1):258. doi: 10.3390/jcm14010258.
: A common problem in pediatric orthopedics is leg length discrepancy (LLD). In adulthood, this may result in overload and degenerative changes in the lumbar spine, hip, and knee joints of the longer limb, and the fixed equinus position of the foot of the shorter limb. Surgical treatment using temporary epiphysiodesis with eight-plate implants is a minimally invasive, safe, and patient-tolerated procedure in LLD. However, publications mainly describe the effects of treatment in the form of achieved equalization and there is little information about the occurrence of secondary deformations. Our study aimed to determine the effect of temporary growth plate blocking on the final axis after treatment. : The study was based on an analysis of radiographs recorded from 2010 to 2019 and an assessment of parameters such as MAD (mechanical axis deviation), mMPTA (mechanical medial proximal tibial angle), and M/at (mechanical axis of the tibia). : Twenty-four girls and thirty-six boys treated with eight-plate implants were included in the investigation. The duration of the treatment was 18 months (group I), 30 months (group II), and 42 months (group III). Our study revealed that the most significant differences were observed in the MAD parameter. MAD changed in a statistically significant manner across all investigated groups, for both girls and boys, regardless of the treatment duration. : The treatment of LLD with epiphysiodesis using eight-plate implants influences both the anatomical axis of the bones and the mechanical axis of the limb.
小儿骨科的一个常见问题是下肢长度差异(LLD)。在成年期,这可能导致较长肢体的腰椎、髋关节和膝关节出现负荷过重和退行性改变,以及较短肢体的足部出现固定性马蹄足畸形。使用八板植入物进行临时骨骺阻滞的手术治疗是一种微创、安全且患者耐受的治疗LLD的方法。然而,出版物主要以实现肢体长度均等化的形式描述治疗效果,关于继发畸形发生情况的信息很少。我们的研究旨在确定临时生长板阻滞对治疗后最终轴线的影响。
该研究基于对2010年至2019年记录的X线片的分析以及对诸如机械轴偏差(MAD)、机械性胫骨近端内侧角(mMPTA)和胫骨机械轴(M/at)等参数的评估。
本研究纳入了24名接受八板植入物治疗的女孩和36名接受八板植入物治疗的男孩。治疗持续时间分别为18个月(I组)、30个月(II组)和42个月(III组)。我们的研究表明,在MAD参数上观察到的差异最为显著。无论治疗持续时间如何,所有研究组的女孩和男孩的MAD均有统计学意义的变化。
使用八板植入物进行骨骺阻滞治疗LLD会影响骨骼的解剖轴和肢体的机械轴。