Please use this identifier to cite or link to this item: https://hdl.handle.net/20.500.11851/10774
Title: Does the Sleeper Plate Application for Temporary Epiphysiodesis Make Life Easier or Complicated? Increased Risk of Tethering
Authors: Bakircioglu, S.
Kolac, U.C.
Yigit, Y.A.
Aksoy, T.
Aksoy, M.C.
Yazici, M.
Yilmaz, G.
Keywords: guided growth
hemiepiphysiodesis
lower limb
Article
child
cystinosis
dysplasia
epiphysiodesis
exostosis
female
follow up
hemihypertrophy
hemimelia
hereditary multiple exostosis
human
limb deformity
lower limb
major clinical study
male
metaphysis
retrospective study
sleeper plate technique
arthrodesis
bone plate
knee
limb
plastic surgery
postoperative complication
surgery
Arthrodesis
Bone Plates
Child
Extremities
Humans
Knee Joint
Plastic Surgery Procedures
Postoperative Complications
Retrospective Studies
Issue Date: 2023
Publisher: Lippincott Williams and Wilkins
Abstract: Background: The present study aims to investigate the frequency of recurrence and tethering effect after only metaphyseal screw removal (sleeper plate technique) compared with the conventional complete plate removal in the treatment of lower extremity deformities with guided growth surgery. Methods: Seventy-two patients (107 limbs) treated by an 8-plate hemiepiphysiodesis technique around the knee joint were evaluated. After the desired correction, only metaphyseal screw was removed (sleeper plate group) in 35 limbs (25 patients), whereas both screws and plate were removed (plate removal group) in 72 limbs (47 patients). An increase of 5 degrees or more in joint orientation angles in the direction of the initial deformity was considered as recurrence. The rate of rebound, tethering, and maintenance of correction in groups was analyzed at the latest follow-up (mean of 49 mo). Results: The mean age of the patients was 97 months (range: 80 to 129 mo) at the time of index surgery. After a mean of 49 months (range: 16 to 86), 17 (48.5%) limbs maintained the desired stable correction in the sleeper plate group compared with 59 stable limbs (72.2%) in the plate removal group (P<0.001). There was no statistically significant difference regarding recurrence between the sleeper plate group and the plate removal group (34.3% vs. 27.8%, respectively) (P=0.216). Reinsertion of the metaphyseal screw was possible 8/12 limbs, and the remaining 4 limbs underwent further surgeries. There were 6 limbs (17.3%) of tethering in the sleeper plate group, and 4/6 limbs required further corrective surgeries. The remaining 2 limbs with slight tethering did not require further surgeries. Conclusions: Removing only metaphyseal screw increases the risk of tethering. In addition, reinsertion of the screw may not be possible in all cases due to bony growth, and further corrective surgeries may be necessary. Close follow-up is required if the sleeper plate technique is to be applied. Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
URI: https://doi.org/10.1097/BPO.0000000000002489
https://hdl.handle.net/20.500.11851/10774
ISSN: 0271-6798
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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