Please use this identifier to cite or link to this item: https://hdl.handle.net/20.500.11851/10683
Title: The Fate of Overcorrection After Hemiepiphysiodesis in Valgus Deformities Around the Knee
Authors: Aksoy, Taha
Bakırcıoğlu, Sancar
Özdemir, Erdi
Ramazanov, Rafik
Aksoy, Mehmet Cemalettin
Yılmaz, Güney
Keywords: tension band plate
hemiepiphysiodesis
overcorrection
genu valgum
Tension-Band Plates
Growth Modulation
Angular Deformities
Rebound Phenomenon
Genu-Valgum
Children
Removal
Issue Date: 2023
Publisher: Lippincott Williams & Wilkins
Abstract: Background:Tension band plating is widely used in the surgical treatment of coronal plane deformities around the knee. The rebound phenomenon after implant removal is a common complication of this technique. Overcorrection of joint orientation angles is a method to minimize the effect of the rebound phenomenon. This study aims to investigate the natural course of overcorrected joint orientation angles after plate removal in patients with genu valgum deformity. Methods:Patients who underwent hemiepiphysiodesis with tension band plating due to genu valgum deformity between 2010 and 2019 were retrospectively analyzed. Mechanical lateral distal femoral angles (mLDFA) and mechanical medial proximal tibial angles were calculated before plate application, before implant removal, and at the last follow-up. At the implant removal, mLDFA>90 degrees and mechanical medial proximal tibial angles Results:Seventy-two segments from 45 patients were included. For femoral valgus deformities (n=59), the mean mLDFAs at index surgery, implant removal, and the last follow-up were 79.8 & PLUSMN;3.9 degrees, 95.5 & PLUSMN;3.7 degrees, and 87.3 & PLUSMN;5.1 degrees, respectively. In the more and less than 10 degrees rebound groups, the median age of patients at index surgery were 66 and 101 months (P=0.04), the mLDFA during implant removal were 97.8 degrees and 94.4 degrees (P=0.005), and the mean amount of correction in mLDFA was 17 degrees and 13 degrees (P=0.001), respectively. At the last follow-up, joint orientation angles were found to be still overcorrected in 16 (22%), within normal limits in 36 (50%), and undercorrected in 20 (28%) segments. Ten (13%) segments required additional surgery due to residual deformity. Conclusions:Overcorrection with tension band plating is an effective modality in the treatment of genu valgum deformity. Rebound after plate removal increases as the age at index surgery decreases and the amount of conscious overcorrection increases. Most segments return to normal joint orientation angle limits after overcorrection. We recommend a mean of 5 degrees routine overcorrection in patients with genu valgum deformity to overcome the rebound phenomenon and to make future interventions easier if ever needed.
URI: https://doi.org/10.1097/BPO.0000000000002429
https://hdl.handle.net/20.500.11851/10683
ISSN: 0271-6798
1539-2570
Appears in Collections:PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Scopus İndeksli Yayınlar Koleksiyonu / Scopus Indexed Publications Collection
WoS İndeksli Yayınlar Koleksiyonu / WoS Indexed Publications Collection

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