Failure of orthofix eight-plate for the treatment of blount disease

Samuel Schroerlucke, Styles L Bertrand, John Clapp, Justin Bundy, Frederick O. Gregg

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

BACKGROUND: Hemiepiphysiodesis is a well-established treatment option for angular deformities of the knee. Recently, our institution began using the eight-Plate tension band device by Orthofix (McKinney, Tex) as an alternative to staples. However, several patients have returned with broken screws necessitating revision surgery. METHODS: Charts and radiographs of all patients who were treated with the eight-Plate (Orthofix) at our institution were reviewed. The diagnosis, age, amount of angular deformity, weight, and body mass index were analyzed with respect to eventual implant failure. RESULTS: Implant failure occurred in 8 (26%) of 31 proximal tibia constructs. All 8 failures occurred in patients with Blount disease and involved breakage of the tibial metaphyseal screw. The mean time to failure was 13.6 months. Eight hardware failures in 18 Blount disease extremities represent a failure rate of 44%. No implant failures occurred in the remaining diagnoses. Neither age nor degree of deformity correlated with implant failure. The failure group was significantly heavier than the nonfailure group, and the patients with Blount disease were found to be heavier than the other patients. However, no significant difference in weight was found within the Blount group regarding implant failure. In all patients whose plates did not fail, rate of correction was equal to or better than previously reported hemiepiphysiodesis studies. CONCLUSIONS: The eight-Plate (Orthofix) is a reasonable option for hemiepiphysiodesis but has an unacceptable failure rate in Blount disease (44%). There were no instances of failure in patients with other diagnoses. In Blount disease, stronger implants should be considered. Future implant designs should include stronger screws to decrease implant failure complications. LEVEL OF EVIDENCE: Level 3.

Original languageEnglish (US)
Pages (from-to)57-60
Number of pages4
JournalJournal of Pediatric Orthopaedics
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2009

Fingerprint

Therapeutics
Weights and Measures
Blount disease
Tibia
Reoperation
Knee
Body Mass Index
Extremities
Equipment and Supplies

Keywords

  • Angular
  • Blount
  • Deformity
  • Genu valgum
  • Genu varum
  • Hemiepiphysiodesis
  • Implant failure
  • Osteotomy
  • Screw breakage
  • Screw failure
  • Screw size
  • Staples
  • Tension band

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Schroerlucke, S., Bertrand, S. L., Clapp, J., Bundy, J., & Gregg, F. O. (2009). Failure of orthofix eight-plate for the treatment of blount disease. Journal of Pediatric Orthopaedics, 29(1), 57-60. https://doi.org/10.1097/BPO.0b013e3181919b54

Failure of orthofix eight-plate for the treatment of blount disease. / Schroerlucke, Samuel; Bertrand, Styles L; Clapp, John; Bundy, Justin; Gregg, Frederick O.

In: Journal of Pediatric Orthopaedics, Vol. 29, No. 1, 01.01.2009, p. 57-60.

Research output: Contribution to journalArticle

Schroerlucke, S, Bertrand, SL, Clapp, J, Bundy, J & Gregg, FO 2009, 'Failure of orthofix eight-plate for the treatment of blount disease', Journal of Pediatric Orthopaedics, vol. 29, no. 1, pp. 57-60. https://doi.org/10.1097/BPO.0b013e3181919b54
Schroerlucke, Samuel ; Bertrand, Styles L ; Clapp, John ; Bundy, Justin ; Gregg, Frederick O. / Failure of orthofix eight-plate for the treatment of blount disease. In: Journal of Pediatric Orthopaedics. 2009 ; Vol. 29, No. 1. pp. 57-60.
@article{195bf88eb77341ebb8cb727db3e9e1ea,
title = "Failure of orthofix eight-plate for the treatment of blount disease",
abstract = "BACKGROUND: Hemiepiphysiodesis is a well-established treatment option for angular deformities of the knee. Recently, our institution began using the eight-Plate tension band device by Orthofix (McKinney, Tex) as an alternative to staples. However, several patients have returned with broken screws necessitating revision surgery. METHODS: Charts and radiographs of all patients who were treated with the eight-Plate (Orthofix) at our institution were reviewed. The diagnosis, age, amount of angular deformity, weight, and body mass index were analyzed with respect to eventual implant failure. RESULTS: Implant failure occurred in 8 (26{\%}) of 31 proximal tibia constructs. All 8 failures occurred in patients with Blount disease and involved breakage of the tibial metaphyseal screw. The mean time to failure was 13.6 months. Eight hardware failures in 18 Blount disease extremities represent a failure rate of 44{\%}. No implant failures occurred in the remaining diagnoses. Neither age nor degree of deformity correlated with implant failure. The failure group was significantly heavier than the nonfailure group, and the patients with Blount disease were found to be heavier than the other patients. However, no significant difference in weight was found within the Blount group regarding implant failure. In all patients whose plates did not fail, rate of correction was equal to or better than previously reported hemiepiphysiodesis studies. CONCLUSIONS: The eight-Plate (Orthofix) is a reasonable option for hemiepiphysiodesis but has an unacceptable failure rate in Blount disease (44{\%}). There were no instances of failure in patients with other diagnoses. In Blount disease, stronger implants should be considered. Future implant designs should include stronger screws to decrease implant failure complications. LEVEL OF EVIDENCE: Level 3.",
keywords = "Angular, Blount, Deformity, Genu valgum, Genu varum, Hemiepiphysiodesis, Implant failure, Osteotomy, Screw breakage, Screw failure, Screw size, Staples, Tension band",
author = "Samuel Schroerlucke and Bertrand, {Styles L} and John Clapp and Justin Bundy and Gregg, {Frederick O.}",
year = "2009",
month = "1",
day = "1",
doi = "10.1097/BPO.0b013e3181919b54",
language = "English (US)",
volume = "29",
pages = "57--60",
journal = "Journal of Pediatric Orthopaedics",
issn = "0271-6798",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Failure of orthofix eight-plate for the treatment of blount disease

AU - Schroerlucke, Samuel

AU - Bertrand, Styles L

AU - Clapp, John

AU - Bundy, Justin

AU - Gregg, Frederick O.

PY - 2009/1/1

Y1 - 2009/1/1

N2 - BACKGROUND: Hemiepiphysiodesis is a well-established treatment option for angular deformities of the knee. Recently, our institution began using the eight-Plate tension band device by Orthofix (McKinney, Tex) as an alternative to staples. However, several patients have returned with broken screws necessitating revision surgery. METHODS: Charts and radiographs of all patients who were treated with the eight-Plate (Orthofix) at our institution were reviewed. The diagnosis, age, amount of angular deformity, weight, and body mass index were analyzed with respect to eventual implant failure. RESULTS: Implant failure occurred in 8 (26%) of 31 proximal tibia constructs. All 8 failures occurred in patients with Blount disease and involved breakage of the tibial metaphyseal screw. The mean time to failure was 13.6 months. Eight hardware failures in 18 Blount disease extremities represent a failure rate of 44%. No implant failures occurred in the remaining diagnoses. Neither age nor degree of deformity correlated with implant failure. The failure group was significantly heavier than the nonfailure group, and the patients with Blount disease were found to be heavier than the other patients. However, no significant difference in weight was found within the Blount group regarding implant failure. In all patients whose plates did not fail, rate of correction was equal to or better than previously reported hemiepiphysiodesis studies. CONCLUSIONS: The eight-Plate (Orthofix) is a reasonable option for hemiepiphysiodesis but has an unacceptable failure rate in Blount disease (44%). There were no instances of failure in patients with other diagnoses. In Blount disease, stronger implants should be considered. Future implant designs should include stronger screws to decrease implant failure complications. LEVEL OF EVIDENCE: Level 3.

AB - BACKGROUND: Hemiepiphysiodesis is a well-established treatment option for angular deformities of the knee. Recently, our institution began using the eight-Plate tension band device by Orthofix (McKinney, Tex) as an alternative to staples. However, several patients have returned with broken screws necessitating revision surgery. METHODS: Charts and radiographs of all patients who were treated with the eight-Plate (Orthofix) at our institution were reviewed. The diagnosis, age, amount of angular deformity, weight, and body mass index were analyzed with respect to eventual implant failure. RESULTS: Implant failure occurred in 8 (26%) of 31 proximal tibia constructs. All 8 failures occurred in patients with Blount disease and involved breakage of the tibial metaphyseal screw. The mean time to failure was 13.6 months. Eight hardware failures in 18 Blount disease extremities represent a failure rate of 44%. No implant failures occurred in the remaining diagnoses. Neither age nor degree of deformity correlated with implant failure. The failure group was significantly heavier than the nonfailure group, and the patients with Blount disease were found to be heavier than the other patients. However, no significant difference in weight was found within the Blount group regarding implant failure. In all patients whose plates did not fail, rate of correction was equal to or better than previously reported hemiepiphysiodesis studies. CONCLUSIONS: The eight-Plate (Orthofix) is a reasonable option for hemiepiphysiodesis but has an unacceptable failure rate in Blount disease (44%). There were no instances of failure in patients with other diagnoses. In Blount disease, stronger implants should be considered. Future implant designs should include stronger screws to decrease implant failure complications. LEVEL OF EVIDENCE: Level 3.

KW - Angular

KW - Blount

KW - Deformity

KW - Genu valgum

KW - Genu varum

KW - Hemiepiphysiodesis

KW - Implant failure

KW - Osteotomy

KW - Screw breakage

KW - Screw failure

KW - Screw size

KW - Staples

KW - Tension band

UR - http://www.scopus.com/inward/record.url?scp=60549117681&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=60549117681&partnerID=8YFLogxK

U2 - 10.1097/BPO.0b013e3181919b54

DO - 10.1097/BPO.0b013e3181919b54

M3 - Article

C2 - 19098648

AN - SCOPUS:60549117681

VL - 29

SP - 57

EP - 60

JO - Journal of Pediatric Orthopaedics

JF - Journal of Pediatric Orthopaedics

SN - 0271-6798

IS - 1

ER -