Open Access
American Research Journal of Orthopedics and Traumatology
ISSN (Online): 2572-2964
DOI: 10.46568/arjot
TREATMENT OF GENU VALGUM IN CHILDREN METHOD OF TEMPORARY HEMIEPIPHYSIODESIS USING EIGHTPLATES: SHORT-TERM OUTCOME
Abstract
Background: Angular deformities of the lower extremities cause activity-related pain, altered gait mechanics, and
joint instability, and these are exacerbated by periods of growth. Conservative usually fails to correct deformity;
correction of deformity by hemiepiphysiodesis has become the standard surgical technique of treatment.
Objective: The aim of this study to evaluate temporary hemiepiphysiodesis around the knee to modulate growth
with eight-Plate technique in patient with genu valgum.
Material and method: A prospective study between January 2015 and December 2019, we evaluated the patients
as a single group to assess the effectiveness of temporary hemiepiphysiodesis as a method of correction of genu
valgum. The study included 29 patients with one patient was male and had unilateral valgus left knee and was lost
in the follow up after removal of the plate and the remaining 28 patients were 22 bilateral 78.6% and 6 unilateral
22.4% (50 knees) four patients with right side14.3% and two patient left side 7.1% with coronal genu valgum
deformity indicated for surgical treatment. There were 19 boys (67.8%) and 9 girls (32.2%) and all of them were
treated by temporary hemiepiphysiodesis using eight-plate technique. The mean average age of the children at a
time of the operation was 7.8±2.3`years (range, 4–12.5 years).
Result: The entire patient had complete correction of the deformity. The mean follow-up was 31±7.8 months
(range 20-48 months) after plate removal. Two patients reached skeletal maturity at the final follow up. The eightplates
were inserted on the medial distal femur (MDF) in 6 patients (21.4%), in proximal tibia (MPT) in 6 (21.4%)
patients and on both femur and tibia (MPT+MDF) in 16 patients (57.2%). All patients achieved complete deformity
correction after plate removal mean duration 19±4.6 months (14-29 months) and the mean Intermalleolar
distances before the procedure was 19.2±4.3 changed postoperative to 1.2±1 with P. value > 0.001 and the mean
mLDFA changed from 79.2±5 to 87.2±1.5 and the P. value > 0.001 after the procedure.
Conclusion: Temporary hemiepiphysiodesis using eight-Plates is a delicate, straight forward and successful
strategy used to treat genu valgum by modulating growth. Slight overcorrection is alluring because of the
rebound phenomenon, particularly in young patients with high development potential and risk groups, for
example, obese children.
joint instability, and these are exacerbated by periods of growth. Conservative usually fails to correct deformity;
correction of deformity by hemiepiphysiodesis has become the standard surgical technique of treatment.
Objective: The aim of this study to evaluate temporary hemiepiphysiodesis around the knee to modulate growth
with eight-Plate technique in patient with genu valgum.
Material and method: A prospective study between January 2015 and December 2019, we evaluated the patients
as a single group to assess the effectiveness of temporary hemiepiphysiodesis as a method of correction of genu
valgum. The study included 29 patients with one patient was male and had unilateral valgus left knee and was lost
in the follow up after removal of the plate and the remaining 28 patients were 22 bilateral 78.6% and 6 unilateral
22.4% (50 knees) four patients with right side14.3% and two patient left side 7.1% with coronal genu valgum
deformity indicated for surgical treatment. There were 19 boys (67.8%) and 9 girls (32.2%) and all of them were
treated by temporary hemiepiphysiodesis using eight-plate technique. The mean average age of the children at a
time of the operation was 7.8±2.3`years (range, 4–12.5 years).
Result: The entire patient had complete correction of the deformity. The mean follow-up was 31±7.8 months
(range 20-48 months) after plate removal. Two patients reached skeletal maturity at the final follow up. The eightplates
were inserted on the medial distal femur (MDF) in 6 patients (21.4%), in proximal tibia (MPT) in 6 (21.4%)
patients and on both femur and tibia (MPT+MDF) in 16 patients (57.2%). All patients achieved complete deformity
correction after plate removal mean duration 19±4.6 months (14-29 months) and the mean Intermalleolar
distances before the procedure was 19.2±4.3 changed postoperative to 1.2±1 with P. value > 0.001 and the mean
mLDFA changed from 79.2±5 to 87.2±1.5 and the P. value > 0.001 after the procedure.
Conclusion: Temporary hemiepiphysiodesis using eight-Plates is a delicate, straight forward and successful
strategy used to treat genu valgum by modulating growth. Slight overcorrection is alluring because of the
rebound phenomenon, particularly in young patients with high development potential and risk groups, for
example, obese children.
