|Beitragstitel||Low Budget Plating for hemiepiphyseodesis around the knee in expensive medical times|
To retrospectively review our results with special focus on implant related failures when using a simple two hole plate with solid cancellous screws for hemiepiphyseodesis around the knee in the adolescent.
Patients and method:
Since 2007 we have used a simple two hole titanium foot plate 711 times in the femur and the tibia or in both . There were 356 hemiepiphyseodeses in the tibia and 355 in the femur in 338 patients. Of these there were 144 girls and 194 boys. The average age at implantation of the plates was 12 years in girls and approximately 13.5 years in boys. The main indication was bilateral valgus deformity of the knee with a lateralization of the mechanical axis of over 12 mm, less common was the treatment of a medialization of the mechanical axis in varus deformity of over 16 mm. For fixation of the plate we used simple solid cancellous 4.0 screws. The surgical technique is little different to that used with cannulated screws, however faster and with less radiation time.
We observed only few device related problems. In the beginning, when we used titanium screws we had to face some breakages of the screws during explantation, but since we used solid steal screws no such breakages were seen anymore. A loosening of the screws was never seen. The plate never broke, even not in severe deformities and long term implantation.
Based on our experience, especially for the experienced pediatric orthopaedic surgeon a simple two hole plate fixed with solid cancellous screws is a perfect device for growth guidance in the adolescent patient. It is not only less expensive but furthermore quicker to implant with less radiation time and has no higher (and probably a lesser) complication rate in comparison to usually used plate systems.