Guided growth: 1933 to the present

While osteotomies are necessary for rotational correction and limb lengthening, angular correction or moderate length inhibition may be achieved by other, less invasive means. Several techniques of epiphysiodesis have evolved, enabling gradual correction of angular correction and/or length equalisation through guided growth. This manuscript comprises a historical and comparative review of those techniques. The 8-plate method of guided growth affords the opportunity to provide a tension band (rather than compression) that expedites angular correction, compared to stapling or transphyseal screws, which rely upon the principle of compression. When applied to each side of a given physis, longitudinal growth is inhibited, in the same fashion as stapling or epiphysiodesis. The physis and periosteum are spared any direct insult, thus making this a reversible process, suitable for use in younger children. The 8-plate is simple to insert and, compared to staples or transphyseal screws, easy to remove.