104.
Is 8-plates superior to staples in the treatment of idiopathic genu
valgus? A randomized clinical study.
Martin Gottliebsen, Ole Rahbek, Ivan Hvid, Michael Davidsen, Michel Bach
Hellfritzsch, Bjarne Møller-Madsen
Department of Children`s Orthopaedics Aarhus University Hospital;
Department of Children`s Orthopaedics, Aarhus University Hospital;
Department of Children`s Orthopaedics, Aarhus University Hospital;
Department of Children`s Orthopaedics, Aarhus University Hospital;
Department of Radiology, Aarhus University Hospital; Department of
Children`s Orthopaedics, Aarhus University Hospital
Background:
In children with excessive angulating deformities of the lower
limbs guided growth can be used to achieve better alignment before skeletal
maturity. Traditionally hemiepiphysiodesis has been performed with staple
technique. The 8-plate technique was introduced in 2007 and has theoretical
advantages compared to stapling. The benefit of the 8-plate technique has not
yet been proven in randomised clinical studies.
Purpose / Aim of Study:
To compare the clinical and radiological effects of
stapling with those of 8-plates in a group of children with idiopathic genu
valgus.
Materials and Methods:
Children with bilateral idiopathic genu valgus were
randomized to staple or 8-plate hemiepiphysiodesis (n=26). Time needed to
correct deformity was recorded and changes in lower limb mechanical axis on
long standing x-rays were measured. Pain score using visual analog scale
(
VAS) was performed for 72 hours postoperatively as well as registration of
analgesics taken.
Findings / Results:
20
children were eligible for analysis (10 in each group).
Mean treatment time between staples (349 days) and 8-plates (340 days) did
not differ. No difference in changes in mechanical axis was found between
staples (14.4 dgr) and 8-plates (13.9 dgr). VAS score and consumption of
analgesics postoperatively did not differ between groups. No hardware failure
or wound related infections were observed.
Conclusions:
There seem to be similar effect of 8-plates and staples in relation
to correction of genu valgus. We cannot rule out that we have made a type II
error and that our study is underpowered. However, we do not believe that
smaller differences found in larger studies will be of clinical significance.
