TY - JOUR
T1 - Guided growth for the Treatment of Infantile Blount's disease
T2 - Is it a viable option?
AU - Griswold, B. Gage
AU - Shaw, K. Aaron
AU - Houston, Harrison
AU - Bertrand, Styles
AU - Cearley, David
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Introduction: Guided growth with temporary hemiepiphysiodesis has gained interest as a less invasive means for the treatment of coronal plane lower extremity deformities as well as leg length discrepancies. Its application to infantile Blount's disease has been less reported. The object of this study was to identify predictive factors of guided growth for treatment of infantile Blount's. Methods: A retrospective review was performed of children undergoing guided growth for the treatment of infantile Blount's disease over an eight-year period. Inclusion criteria included treatment with THE for infantile Blount's disease. Clinical information, preoperative Langenskiold classification, and intra-operative and post-operative data. Preoperative variables were used to identify risk factors for speed of correction and the need for subsequent surgery. Results: A total of 11 patients, 17 extremities, meeting inclusionary criteria. Preoperatively, 7 extremities were classified as Langenskiold stage ≥3, with 12 being classified as stage ≤2. Overall, the Drennan's angle improved from 18.3° to 0.3° by final follow-up at an average of 4.31 years. Eight extremities demonstrated deformity recurrence/persistence (stage ≤2:33% vs stage ≥3: 100%), requiring 24 reoperations. Children with Langenskiold stage ≥3 demonstrated a significantly higher rate of reoperation. Conclusion: Guided growth is a viable treatment option for Infantile Blount's disease presenting with Langenskiold stage ≤2 disease at treatment initiation. The treatment course can expect a 33% rate of recurrent deformity, treated successfully with repeat THE. No child stage ≤2 required corrective osteotomy. Caution should be used when considering guided growth for children presenting with Langenskiold stage ≥3.
AB - Introduction: Guided growth with temporary hemiepiphysiodesis has gained interest as a less invasive means for the treatment of coronal plane lower extremity deformities as well as leg length discrepancies. Its application to infantile Blount's disease has been less reported. The object of this study was to identify predictive factors of guided growth for treatment of infantile Blount's. Methods: A retrospective review was performed of children undergoing guided growth for the treatment of infantile Blount's disease over an eight-year period. Inclusion criteria included treatment with THE for infantile Blount's disease. Clinical information, preoperative Langenskiold classification, and intra-operative and post-operative data. Preoperative variables were used to identify risk factors for speed of correction and the need for subsequent surgery. Results: A total of 11 patients, 17 extremities, meeting inclusionary criteria. Preoperatively, 7 extremities were classified as Langenskiold stage ≥3, with 12 being classified as stage ≤2. Overall, the Drennan's angle improved from 18.3° to 0.3° by final follow-up at an average of 4.31 years. Eight extremities demonstrated deformity recurrence/persistence (stage ≤2:33% vs stage ≥3: 100%), requiring 24 reoperations. Children with Langenskiold stage ≥3 demonstrated a significantly higher rate of reoperation. Conclusion: Guided growth is a viable treatment option for Infantile Blount's disease presenting with Langenskiold stage ≤2 disease at treatment initiation. The treatment course can expect a 33% rate of recurrent deformity, treated successfully with repeat THE. No child stage ≤2 required corrective osteotomy. Caution should be used when considering guided growth for children presenting with Langenskiold stage ≥3.
KW - Genu varum
KW - Guided growth
KW - Infantile Blount's
KW - Knee
KW - Temporary hemiepiphysiodesis
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U2 - 10.1016/j.jor.2020.01.007
DO - 10.1016/j.jor.2020.01.007
M3 - Article
AN - SCOPUS:85078417480
VL - 20
SP - 41
EP - 45
JO - Journal of Orthopaedics
JF - Journal of Orthopaedics
SN - 0972-978X
ER -