Factors influencing the speed of correction speed of distal tibial valgus deformity in children with percutaneous epiphyseodesis using transphyseal screw.
Chakravarthy Ugandhar Dussa, Harald Böhm, Florian Meister
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引用次数: 0
Abstract
Introduction: The distal tibial valgus deformity in children mimics a hindfoot valgus and is observed in several conditions of both non-neurogenic and neurogenic origin. The deformity can only be detected with radiological examination and can be safely and effectively corrected in children with medial percutaneous epiphysiodesis using transphyseal screws (PETS). The aims of the study are: 1. to determine the correction rates of the distal tibial valgus deformity due to different pathologies, 2. to examine the correction rate in relation to the age at implantation, severity of the initial deformity and the duration of implantation, 3. and types of foot deformities associated with the deformity.
Materials and methods: A retrospective study was done on children who underwent a PETS for a distal tibial valgus deformity. The lateral distal tibia angle 89° ± 3° on ankle mortice x-rays was taken as normal. An analysis of variance and covariance was done to investigate differences in parameters between aetiologies and relations between parameters respectively.
Results: Following exclusion of 191 limbs, 155 limbs in 104 children were included the study, 5 groups could be identified: Idiopathic, ICP (cerebral palsy), MMC (Meningomyelocele), Dysmelia, MHE (multiple hereditary exostosis). The mean age at implantation of all patients was 10.9 ± 1.4 years. The average correction of 0.45° ± 0.08°/month with no significant differences in the correction rates between groups. However, the correction rates were dependent on the age, the initial deformity and the duration of treatment. The incidence of a valgus foot deformity was 86.4 %.
Conclusion: The correction rates of the distal tibial valgus deformity following PETS are variable and depend, on the age at implantation, duration of treatment and initial deformity. The spectrum of foot deformities associated with distal tibial valgus deformity, especially a high prevalence of valgus foot deformity warrants an ankle mortice x-ray.
Level of evidence: Level III, retrospective study.
期刊介绍：
Foot and Ankle Surgery is essential reading for everyone interested in the foot and ankle and its disorders. The approach is broad and includes all aspects of the subject from basic science to clinical management. Problems of both children and adults are included, as is trauma and chronic disease. Foot and Ankle Surgery is the official journal of European Foot and Ankle Society.
The aims of this journal are to promote the art and science of ankle and foot surgery, to publish peer-reviewed research articles, to provide regular reviews by acknowledged experts on common problems, and to provide a forum for discussion with letters to the Editors. Reviews of books are also published. Papers are invited for possible publication in Foot and Ankle Surgery on the understanding that the material has not been published elsewhere or accepted for publication in another journal and does not infringe prior copyright.
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