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Temporary Proximal Tibial Epiphysiodesis for Correction of Leg Length Discrepancy in Children—Should Proximal Fibular Epiphysiodesis Be Performed Concomitantly?

The need for concomitant proximal fibular epiphysiodesis (PFE) when correcting leg length discrepancy (LLD) with temporary proximal tibial epiphysiodesis (PTE) in children is controversially discussed. This single center, retrospective cohort study analyzes proximal fibular growth in patients treate...

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Autores principales: Frommer, Adrien, Niemann, Maike, Gosheger, Georg, Eveslage, Maria, Toporowski, Gregor, Laufer, Andrea, Ackmann, Thomas, Roedl, Robert, Vogt, Bjoern
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002647/
https://www.ncbi.nlm.nih.gov/pubmed/33802874
http://dx.doi.org/10.3390/jcm10061245
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author Frommer, Adrien
Niemann, Maike
Gosheger, Georg
Eveslage, Maria
Toporowski, Gregor
Laufer, Andrea
Ackmann, Thomas
Roedl, Robert
Vogt, Bjoern
author_facet Frommer, Adrien
Niemann, Maike
Gosheger, Georg
Eveslage, Maria
Toporowski, Gregor
Laufer, Andrea
Ackmann, Thomas
Roedl, Robert
Vogt, Bjoern
author_sort Frommer, Adrien
collection PubMed
description The need for concomitant proximal fibular epiphysiodesis (PFE) when correcting leg length discrepancy (LLD) with temporary proximal tibial epiphysiodesis (PTE) in children is controversially discussed. This single center, retrospective cohort study analyzes proximal fibular growth in patients treated by PTE with and without concomitant PFE. Radiographic measurements were conducted before implantation and at implant removal. The position of the fibular head in relation to the tibia was assessed with recently established radiographic reference values. All patients (n = 58, 19 females) received PTE to treat LLD at a mean age of 12.2 years (range 7 to 15). In 27/58 (47%) concomitant PFE was performed. Mean follow-up was 36.2 months (range 14.2 to 78.0). The position of the proximal fibula at implant removal was within physiological range in 21/26 patients (81%) with PFE and in 21/30 patients (70%) without PFE. Proximal fibular overgrowth newly developed in 2/26 patients (8%) treated with PFE and in 5/30 patients (17%) treated without PFE (p = 0.431). Peroneal nerve injury or discomfort due to proximal fibular overlength was not reported. The position of the proximal fibula should be critically assessed preoperatively under consideration of reference values before PTE. In consequence of this study, the authors do not routinely perform PFE concomitantly with PTE for correction of moderate LLD in children if the proximal fibula is localized within physiological radiographic margins determined by the established reference values.
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spelling pubmed-80026472021-03-28 Temporary Proximal Tibial Epiphysiodesis for Correction of Leg Length Discrepancy in Children—Should Proximal Fibular Epiphysiodesis Be Performed Concomitantly? Frommer, Adrien Niemann, Maike Gosheger, Georg Eveslage, Maria Toporowski, Gregor Laufer, Andrea Ackmann, Thomas Roedl, Robert Vogt, Bjoern J Clin Med Article The need for concomitant proximal fibular epiphysiodesis (PFE) when correcting leg length discrepancy (LLD) with temporary proximal tibial epiphysiodesis (PTE) in children is controversially discussed. This single center, retrospective cohort study analyzes proximal fibular growth in patients treated by PTE with and without concomitant PFE. Radiographic measurements were conducted before implantation and at implant removal. The position of the fibular head in relation to the tibia was assessed with recently established radiographic reference values. All patients (n = 58, 19 females) received PTE to treat LLD at a mean age of 12.2 years (range 7 to 15). In 27/58 (47%) concomitant PFE was performed. Mean follow-up was 36.2 months (range 14.2 to 78.0). The position of the proximal fibula at implant removal was within physiological range in 21/26 patients (81%) with PFE and in 21/30 patients (70%) without PFE. Proximal fibular overgrowth newly developed in 2/26 patients (8%) treated with PFE and in 5/30 patients (17%) treated without PFE (p = 0.431). Peroneal nerve injury or discomfort due to proximal fibular overlength was not reported. The position of the proximal fibula should be critically assessed preoperatively under consideration of reference values before PTE. In consequence of this study, the authors do not routinely perform PFE concomitantly with PTE for correction of moderate LLD in children if the proximal fibula is localized within physiological radiographic margins determined by the established reference values. MDPI 2021-03-17 /pmc/articles/PMC8002647/ /pubmed/33802874 http://dx.doi.org/10.3390/jcm10061245 Text en © 2021 by the authors. 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 (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Frommer, Adrien
Niemann, Maike
Gosheger, Georg
Eveslage, Maria
Toporowski, Gregor
Laufer, Andrea
Ackmann, Thomas
Roedl, Robert
Vogt, Bjoern
Temporary Proximal Tibial Epiphysiodesis for Correction of Leg Length Discrepancy in Children—Should Proximal Fibular Epiphysiodesis Be Performed Concomitantly?
title Temporary Proximal Tibial Epiphysiodesis for Correction of Leg Length Discrepancy in Children—Should Proximal Fibular Epiphysiodesis Be Performed Concomitantly?
title_full Temporary Proximal Tibial Epiphysiodesis for Correction of Leg Length Discrepancy in Children—Should Proximal Fibular Epiphysiodesis Be Performed Concomitantly?
title_fullStr Temporary Proximal Tibial Epiphysiodesis for Correction of Leg Length Discrepancy in Children—Should Proximal Fibular Epiphysiodesis Be Performed Concomitantly?
title_full_unstemmed Temporary Proximal Tibial Epiphysiodesis for Correction of Leg Length Discrepancy in Children—Should Proximal Fibular Epiphysiodesis Be Performed Concomitantly?
title_short Temporary Proximal Tibial Epiphysiodesis for Correction of Leg Length Discrepancy in Children—Should Proximal Fibular Epiphysiodesis Be Performed Concomitantly?
title_sort temporary proximal tibial epiphysiodesis for correction of leg length discrepancy in children—should proximal fibular epiphysiodesis be performed concomitantly?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002647/
https://www.ncbi.nlm.nih.gov/pubmed/33802874
http://dx.doi.org/10.3390/jcm10061245
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