دورية أكاديمية
Percutaneous epiphysiodesis using transphyseal screws (PETS) versus tension-band plating (TBP): comparative study of outcomes for correcting limb length discrepancy.
| العنوان: | Percutaneous epiphysiodesis using transphyseal screws (PETS) versus tension-band plating (TBP): comparative study of outcomes for correcting limb length discrepancy. |
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| المؤلفون: | Younis MH; Division of Pediatric Orthopaedics, Children's Hospital at Montefiore Medical Center, Bronx, NY, USA. Younis.manaf@gmail.com., Hanstein R; Division of Pediatric Orthopaedics, Children's Hospital at Montefiore Medical Center, Bronx, NY, USA., Javed K; Albert Einstein College of Medicine, Bronx, NY, USA., Fornari ED; Division of Pediatric Orthopaedics, Children's Hospital at Montefiore Medical Center, Bronx, NY, USA., Gomez JA; Division of Pediatric Orthopaedics, Children's Hospital at Montefiore Medical Center, Bronx, NY, USA., Sharkey MS; Division of Pediatric Orthopaedics, Children's Hospital at Montefiore Medical Center, Bronx, NY, USA., Schulz JF; Division of Pediatric Orthopaedics, Children's Hospital at Montefiore Medical Center, Bronx, NY, USA. |
| المصدر: | European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2023 Jul; Vol. 33 (5), pp. 1523-1531. Date of Electronic Publication: 2022 Jun 20. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer-Verlag France Country of Publication: France NLM ID: 9518037 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1068 (Electronic) Linking ISSN: 16338065 NLM ISO Abbreviation: Eur J Orthop Surg Traumatol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Paris : Springer-Verlag France |
| مواضيع طبية MeSH: | Leg Length Inequality*/surgery , Arthrodesis*/methods, Child ; Humans ; Retrospective Studies ; Lower Extremity ; Bone Screws |
| مستخلص: | Objectives: The best effective treatment strategy for limb length discrepancy (LLD) is still being debated. The goal of this study was to compare the efficacy and results of tension-band plating (TBP) and percutaneous epiphysiodesis using transphyseal screws (PETS) for LLD correction. Methods: From June 2008 to January 2019, children who had lower extremity epiphysiodesis with either TBP or PETS were reviewed retrospectively. At the conclusion of treatment, LLD, angular deformity, and complications were reviewed. The t-test or Wilcoxon rank sum test was used to compare continuous variables. Categorical variables were evaluated using Fisher's exact test or χ 2 test. Results: A total of 32 epiphysiodeses with TBP (14 patients, 24 femur/tibias) or PETS (13 patients, 23 femur/tibias) were compared. TBPs were conducted while the patients were younger (11.0 vs. 13.1 years, p = 0.005). The treatment durations were similar in both groups (TBP: 23.5 months vs. PETS: 24 months, p = 0.132). PETS had significantly shorter operative time (p = 0.047), length of hospital stay (p = 0.014), and time to return to full activity (p = 0.043). LLD in the TBP group reduced from 2.64 to 1.38 cm (p = 0.005), while in the PETS group it decreased from 2.76 to 1.08 cm (p = 0.001). During treatment, the rate of LLD correction was 0.49 ± 0.9 cm/year for limbs treated with TBP and 1.0 ± 1.1 cm/year for limbs treated with PETS (p = 0.185). At the end of treatment, 8 TBP cases (47%) and 9 PETS cases (60%) had achieved LLD ≤ 2 cm (p = 0.502), and at the most recent follow-up, this had grown to 11 (65%) in the TBP group and 12 (80%) in the PETS group. There were no significant differences in the total number of complications between groups (p > 0.05). Revision surgery was required in 11 TBP and 3 PETS limbs due to persistent LLD or angular deformity (AD) (p = 0.016). Logistic regression did not reveal any significant association between TBP and the rate of complication or revision surgery. Conclusion: PETS and TBP are both effective methods for limb length equalization. PETS, on the other hand, was linked to a shorter operative time, a shorter hospital stay, a faster recovery to pre-operative function, and a lower complication rate. The rate of revision surgery due to persistent LLD or AD was higher in TBP. We advise surgeons against utilizing TBP to correct LLD. Level of Evidence: III. (© 2022. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: Epiphysiodesis; Limb length discrepancy; Percutaneous trans-epiphyseal screws; Tension-band plating |
| تواريخ الأحداث: | Date Created: 20220620 Date Completed: 20230619 Latest Revision: 20230619 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1007/s00590-022-03304-0 |
| PMID: | 35723838 |
| قاعدة البيانات: | MEDLINE |
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