학술논문
Does Combining Drilling and Curettage to Percutaneous Trans-epiphyseal Screws Improve Correction of Limb Length Discrepancy? A Comparative Study.
Document Type
Academic Journal
Author
Younis MH; Saudi Hospital, Mansour Ben Omeir St., Amman, Jordan.; 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.
Source
Publisher: Springer Nature Country of Publication: Switzerland NLM ID: 0137736 Publication Model: eCollection Cited Medium: Print ISSN: 0019-5413 (Print) Linking ISSN: 00195413 NLM ISO Abbreviation: Indian J Orthop Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
0019-5413
Abstract
Objectives: Physeal drilling and curettage (PDC) and percutaneous epiphysiodesis using transphyseal screws (PETS) are among the most widely used techniques to treat leg-length discrepancy (LLD). This study compared the efficacy and outcomes between PETS alone and PETS combined with PDC (PETS + PDC).
Methods: Retrospective study of children who underwent epiphysiodesis of the proximal tibia or distal femur with either PETS or PETS + PDC between 2008 and 2018 at a single institution. Radiographic parameters and complications were reviewed at completion of treatment and most recent follow-up.
Results: A total of 23 epiphysiodeses in 15 patients, average age 13.1 years, with either PETS (13 femur/tibias) or PETS + PDC (10 femur/tibias) were included. PETS patients were treated for a longer time (median: 24 months vs 11 months, p = 0.004), however, follow-up time was similar between groups ( p = 0.577), on average 2.7 years. In the PETS group, LLD decreased from 2.55 to 0.84 cm at most recent follow-up ( p = 0.010), and in the PETS + PDC group from 3.01 to 1.2 cm ( p = 0.005), achieving a correction of 1.71 cm for PETS and 1.83 cm for PETS + PDC ( p = 0.871). A correction of LLD to ≤ 2 cm was achieved in 8 PETS (89%) and 4 PETS + PDC cases (67%) ( p = 0.525). Two PETS patients (22%) and 1 PETS + PDC (17%) patient returned to the OR for further correction due to persistent LLD ( p = 1.000). No differences existed in total number of complications, angular deformity or return to physical activity between groups ( p ≥ 0.05 for each comparison).
Conclusions: This study showed equal efficiency in resolving LLD between the PETS and PETS + PDC procedures with minimal operative complications. Level of Evidence III.
Competing Interests: Conflict of InterestMHY, RH, KJ, EDF, MSS and JFS declare that they have no conflict of interest. JAG reports a consultancy and honoraria with Stryker Spine outside the submitted work.
(© Indian Orthopaedics Association 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)
Methods: Retrospective study of children who underwent epiphysiodesis of the proximal tibia or distal femur with either PETS or PETS + PDC between 2008 and 2018 at a single institution. Radiographic parameters and complications were reviewed at completion of treatment and most recent follow-up.
Results: A total of 23 epiphysiodeses in 15 patients, average age 13.1 years, with either PETS (13 femur/tibias) or PETS + PDC (10 femur/tibias) were included. PETS patients were treated for a longer time (median: 24 months vs 11 months, p = 0.004), however, follow-up time was similar between groups ( p = 0.577), on average 2.7 years. In the PETS group, LLD decreased from 2.55 to 0.84 cm at most recent follow-up ( p = 0.010), and in the PETS + PDC group from 3.01 to 1.2 cm ( p = 0.005), achieving a correction of 1.71 cm for PETS and 1.83 cm for PETS + PDC ( p = 0.871). A correction of LLD to ≤ 2 cm was achieved in 8 PETS (89%) and 4 PETS + PDC cases (67%) ( p = 0.525). Two PETS patients (22%) and 1 PETS + PDC (17%) patient returned to the OR for further correction due to persistent LLD ( p = 1.000). No differences existed in total number of complications, angular deformity or return to physical activity between groups ( p ≥ 0.05 for each comparison).
Conclusions: This study showed equal efficiency in resolving LLD between the PETS and PETS + PDC procedures with minimal operative complications. Level of Evidence III.
Competing Interests: Conflict of InterestMHY, RH, KJ, EDF, MSS and JFS declare that they have no conflict of interest. JAG reports a consultancy and honoraria with Stryker Spine outside the submitted work.
(© Indian Orthopaedics Association 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)