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High Association of Posterior Malleolus Fractures with Spiral Distal Tibial Fractures 总被引:3,自引:0,他引:3
Boraiah S Gardner MJ Helfet DL Lorich DG 《Clinical orthopaedics and related research》2008,466(7):1692-1698
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Rolf D. Burghardt John E. Herzenberg Shawn C. Standard Dror Paley 《Journal of children's orthopaedics》2008,2(3):187-197
Purpose Traditionally, angular deformities are treated by means of osteotomy. In patients who are skeletally immature, this major
intervention can be avoided by influencing or guiding the growth of the affected physis. Recently, a new device was presented
as an alternative to the widely used Blount staple. Stevens developed a technique using a two-hole, non-locking plate with
two screws to perform temporary hemiepiphysiodesis in children. We studied the effectiveness of this new device in correcting
angular deformities in children even younger than 5 years of age.
Methods We evaluated our first series of 11 patients (17 eight-Plates) who underwent treatment for angular deformities of various
origins and were followed to completion of correction. The average age at hemiepiphysiodesis was 10 years and 2 months (age
range 4 years and 11 months–13 years and 8 months). The device was inserted in the lateral distal femur (two cases), the medial
distal femur (eight cases), the lateral proximal tibia (two cases), the medial proximal tibia (four cases), and the medial
distal tibia (one case).
Results The eight-Plate was inserted for an average of 9.5 months (range 5–13 months). The joint orientation angles and the mechanical
axis improved in all patients, with the exception of one 13-year and 8-month-old boy with a resected osteosarcoma and a compromised
growth plate. In valgus cases (12 limbs, 13 eight-Plates), the mechanical axis deviation improved by an average of 30.7 mm
(range 13–55 mm). In varus cases (four limbs, four eight-Plates), the mechanical axis deviation improved by an average of
38.8 mm (range 0–74 mm). No hardware failures, extrusion, growth arrest, or other complications were observed. None of our
patients required an osteotomy or repeat eight-Plate insertion.
Conclusions We consider the eight-Plate to be an ideal tool for treatment of angular deformities in growing children. It allows for precise
insertion and is reliable. It is also less likely to extrude like the Blount staple.
None of the authors received financial support for this study.
The study was approved by our institutional human research committee.
Level of evidence: Level II, retrospective study. 相似文献
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