Cargando…
Factors for Prolonged Pain and Restriction of Movement Following Hemiepiphysiodesis Plating for the Correction of Lower Limb Malalignment in the Frontal Plane: An Explorative Analysis
The correction of valgus leg malalignment in children using implant-mediated growth guidance is widely used and effective. Despite the minimal invasive character of the procedure, a relevant number of patients sustain prolonged pain and limited mobility after temporary hemiepiphysiodesis. Our aim wa...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136852/ https://www.ncbi.nlm.nih.gov/pubmed/37189935 http://dx.doi.org/10.3390/children10040686 |
_version_ | 1785032318679777280 |
---|---|
author | Braun, Sebastian Brenneis, Marco Meurer, Andrea Holder, Jana Stief, Felix |
author_facet | Braun, Sebastian Brenneis, Marco Meurer, Andrea Holder, Jana Stief, Felix |
author_sort | Braun, Sebastian |
collection | PubMed |
description | The correction of valgus leg malalignment in children using implant-mediated growth guidance is widely used and effective. Despite the minimal invasive character of the procedure, a relevant number of patients sustain prolonged pain and limited mobility after temporary hemiepiphysiodesis. Our aim was to investigate implant-associated risk factors (such as implant position and screw angulation), surgical- or anesthesia-related risk factors (such as type of anesthesia, use, and duration), and pressure of tourniquet or duration of surgery for these complications. Thirty-four skeletally immature patients with idiopathic valgus deformities undergoing hemiepiphysiodesis plating from October 2018–July 2022 were enrolled in this retrospective study. Participants were divided into groups with and without prolonged complications (persistent pain, limited mobility of the operated knee between five weeks and six months) after surgery. Twenty-two patients (65%) had no notable complications, while twelve patients (35%) had prolonged complications. Both groups differed significantly in plate position relative to physis (p = 0.049). In addition, both groups showed significant differences in the distribution of implant location (p = 0.016). Group 1 had a shorter duration of surgery than group 2 (32 min vs. 38 min, p = 0.032) and a lower tourniquet pressure (250 mmHg vs. 270 mmHg, p = 0.019). In conclusion, simultaneous plate implantation at the femur and tibia and metaphyseal plate positioning resulted in prolonged pain and a delay of function. In addition, the amplitude of tourniquet pressure or duration of surgery could play a factor. |
format | Online Article Text |
id | pubmed-10136852 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-101368522023-04-28 Factors for Prolonged Pain and Restriction of Movement Following Hemiepiphysiodesis Plating for the Correction of Lower Limb Malalignment in the Frontal Plane: An Explorative Analysis Braun, Sebastian Brenneis, Marco Meurer, Andrea Holder, Jana Stief, Felix Children (Basel) Article The correction of valgus leg malalignment in children using implant-mediated growth guidance is widely used and effective. Despite the minimal invasive character of the procedure, a relevant number of patients sustain prolonged pain and limited mobility after temporary hemiepiphysiodesis. Our aim was to investigate implant-associated risk factors (such as implant position and screw angulation), surgical- or anesthesia-related risk factors (such as type of anesthesia, use, and duration), and pressure of tourniquet or duration of surgery for these complications. Thirty-four skeletally immature patients with idiopathic valgus deformities undergoing hemiepiphysiodesis plating from October 2018–July 2022 were enrolled in this retrospective study. Participants were divided into groups with and without prolonged complications (persistent pain, limited mobility of the operated knee between five weeks and six months) after surgery. Twenty-two patients (65%) had no notable complications, while twelve patients (35%) had prolonged complications. Both groups differed significantly in plate position relative to physis (p = 0.049). In addition, both groups showed significant differences in the distribution of implant location (p = 0.016). Group 1 had a shorter duration of surgery than group 2 (32 min vs. 38 min, p = 0.032) and a lower tourniquet pressure (250 mmHg vs. 270 mmHg, p = 0.019). In conclusion, simultaneous plate implantation at the femur and tibia and metaphyseal plate positioning resulted in prolonged pain and a delay of function. In addition, the amplitude of tourniquet pressure or duration of surgery could play a factor. MDPI 2023-04-04 /pmc/articles/PMC10136852/ /pubmed/37189935 http://dx.doi.org/10.3390/children10040686 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Braun, Sebastian Brenneis, Marco Meurer, Andrea Holder, Jana Stief, Felix Factors for Prolonged Pain and Restriction of Movement Following Hemiepiphysiodesis Plating for the Correction of Lower Limb Malalignment in the Frontal Plane: An Explorative Analysis |
title | Factors for Prolonged Pain and Restriction of Movement Following Hemiepiphysiodesis Plating for the Correction of Lower Limb Malalignment in the Frontal Plane: An Explorative Analysis |
title_full | Factors for Prolonged Pain and Restriction of Movement Following Hemiepiphysiodesis Plating for the Correction of Lower Limb Malalignment in the Frontal Plane: An Explorative Analysis |
title_fullStr | Factors for Prolonged Pain and Restriction of Movement Following Hemiepiphysiodesis Plating for the Correction of Lower Limb Malalignment in the Frontal Plane: An Explorative Analysis |
title_full_unstemmed | Factors for Prolonged Pain and Restriction of Movement Following Hemiepiphysiodesis Plating for the Correction of Lower Limb Malalignment in the Frontal Plane: An Explorative Analysis |
title_short | Factors for Prolonged Pain and Restriction of Movement Following Hemiepiphysiodesis Plating for the Correction of Lower Limb Malalignment in the Frontal Plane: An Explorative Analysis |
title_sort | factors for prolonged pain and restriction of movement following hemiepiphysiodesis plating for the correction of lower limb malalignment in the frontal plane: an explorative analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10136852/ https://www.ncbi.nlm.nih.gov/pubmed/37189935 http://dx.doi.org/10.3390/children10040686 |
work_keys_str_mv | AT braunsebastian factorsforprolongedpainandrestrictionofmovementfollowinghemiepiphysiodesisplatingforthecorrectionoflowerlimbmalalignmentinthefrontalplaneanexplorativeanalysis AT brenneismarco factorsforprolongedpainandrestrictionofmovementfollowinghemiepiphysiodesisplatingforthecorrectionoflowerlimbmalalignmentinthefrontalplaneanexplorativeanalysis AT meurerandrea factorsforprolongedpainandrestrictionofmovementfollowinghemiepiphysiodesisplatingforthecorrectionoflowerlimbmalalignmentinthefrontalplaneanexplorativeanalysis AT holderjana factorsforprolongedpainandrestrictionofmovementfollowinghemiepiphysiodesisplatingforthecorrectionoflowerlimbmalalignmentinthefrontalplaneanexplorativeanalysis AT stieffelix factorsforprolongedpainandrestrictionofmovementfollowinghemiepiphysiodesisplatingforthecorrectionoflowerlimbmalalignmentinthefrontalplaneanexplorativeanalysis |