The efficacy of guided growth as an initial strategy for Blount disease treatment
Abstract Purpose The aim of this study was to evaluate the success of guided growth by temporal hemiepiphysiodesis of the lateral proximal tibia as a first line treatment option for Blount disease. Methods This was a retrospective multicentre study conducted in five centres, covering data on 55 limb...
Gespeichert in:
| Veröffentlicht in: | Journal of children's orthopaedics 2020-08, Vol.14 (4), p.312-317 |
|---|---|
| Hauptverfasser: | , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 317 |
|---|---|
| container_issue | 4 |
| container_start_page | 312 |
| container_title | Journal of children's orthopaedics |
| container_volume | 14 |
| creator | Danino, Barry Rödl, Robert Herzenberg, John E. Shabtai, Lior Grill, Franz Narayanan, Unni Gigi, Roy Segev, Eitan Wientroub, Shlomo |
| description | Abstract
Purpose
The aim of this study was to evaluate the success of guided growth by temporal hemiepiphysiodesis of the lateral proximal tibia as a first line treatment option for Blount disease.
Methods
This was a retrospective multicentre study conducted in five centres, covering data on 55 limbs in 45 patients, with an average follow-up of 24.5 months following plate insertion. Preoperative alignment analysis was compared with three measurements taken postoperatively. The normalization of the mechanical medial proximal tibia angle (mMPTA) was defined as the primary outcome measure.
Results
Mean age at surgery was 9.5 years. Average preoperative mMPTA was 77°. On average, at 24.5 months post-surgery, mMPTA was 86.33°, while 43/55 limbs (78.18%) have achieved normalization (mMPTA 85° to 90°). Average rate of correction was 1° per month. When grouping the children as infantile (11 limbs), juvenile (12 limbs) and adolescent (32 limbs), operated on before the age of four years, between four and ten years and after the age of ten years, respectively, 63.63%, 66.67%, 87.5% have completed correction of deformity during the follow-up period. Interestingly, the femoral component of the deformity has achieved correction as well in 33/55 limbs (64%).
Conclusion
Hemiepiphysiodesis is an effective first line treatment for Blount disease. Overall success rate is good but varies according to child's age. Adolescent Blount has the best chance of achieving full correction while same treatment is less effective in infantile Blount.
Level of evidence: IV |
| doi_str_mv | 10.1302/1863-2548.14.200070 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7453169</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1302_1863-2548.14.200070</sage_id><sourcerecordid>2584371817</sourcerecordid><originalsourceid>FETCH-LOGICAL-c474t-7ea4f1a3babb48240d89e7354a82d61f0995ae9e84a4aaf965aea8fdfb4151bd3</originalsourceid><addsrcrecordid>eNp9kU1r3DAQhkVJaNKkv6AQBLn0slt9WZYvhSb0IxAIhfQsxvbIq-C1UklO2H9fLZts0xx6Gs3omXdmeAn5wNmSSyY-caPlQlTKLLlaCsZYzd6Q4331YP8W_Ii8S-mOMc2axrwlR1KYWkldHZOftyuk6JzvoNvQ4Ogw-x57OsTwmFcUEoWJ-slnDyNNOULGYUNdiPRiDPOUae8TQkKaI0Je45RPyaGDMeH7p3hCfn37env5Y3F98_3q8sv1olO1yosaQTkOsoW2VUYo1psGa1kpMKLX3JVNK8AGjQIF4BpdMjCud63iFW97eUI-73Tv53aNfVdGRxjtffRriBsbwNt_fya_skN4sLWqJNdNEfj4JBDD7xlTtmufOhxHmDDMyQolGy2l1qag56_QuzDHqZxnRWWUrLnhdaHkjupiSCmi2y_Dmd1aZreG2K05liu7s6x0nb28Y9_z7FEB2A5IMODfwf_T_ANmo6DR</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2584371817</pqid></control><display><type>article</type><title>The efficacy of guided growth as an initial strategy for Blount disease treatment</title><source>DOAJ Directory of Open Access Journals</source><source>Sage Journals GOLD Open Access 2024</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><creator>Danino, Barry ; Rödl, Robert ; Herzenberg, John E. ; Shabtai, Lior ; Grill, Franz ; Narayanan, Unni ; Gigi, Roy ; Segev, Eitan ; Wientroub, Shlomo</creator><creatorcontrib>Danino, Barry ; Rödl, Robert ; Herzenberg, John E. ; Shabtai, Lior ; Grill, Franz ; Narayanan, Unni ; Gigi, Roy ; Segev, Eitan ; Wientroub, Shlomo</creatorcontrib><description>Abstract
Purpose
The aim of this study was to evaluate the success of guided growth by temporal hemiepiphysiodesis of the lateral proximal tibia as a first line treatment option for Blount disease.
Methods
This was a retrospective multicentre study conducted in five centres, covering data on 55 limbs in 45 patients, with an average follow-up of 24.5 months following plate insertion. Preoperative alignment analysis was compared with three measurements taken postoperatively. The normalization of the mechanical medial proximal tibia angle (mMPTA) was defined as the primary outcome measure.
Results
Mean age at surgery was 9.5 years. Average preoperative mMPTA was 77°. On average, at 24.5 months post-surgery, mMPTA was 86.33°, while 43/55 limbs (78.18%) have achieved normalization (mMPTA 85° to 90°). Average rate of correction was 1° per month. When grouping the children as infantile (11 limbs), juvenile (12 limbs) and adolescent (32 limbs), operated on before the age of four years, between four and ten years and after the age of ten years, respectively, 63.63%, 66.67%, 87.5% have completed correction of deformity during the follow-up period. Interestingly, the femoral component of the deformity has achieved correction as well in 33/55 limbs (64%).
Conclusion
Hemiepiphysiodesis is an effective first line treatment for Blount disease. Overall success rate is good but varies according to child's age. Adolescent Blount has the best chance of achieving full correction while same treatment is less effective in infantile Blount.
Level of evidence: IV</description><identifier>ISSN: 1863-2521</identifier><identifier>EISSN: 1863-2548</identifier><identifier>DOI: 10.1302/1863-2548.14.200070</identifier><identifier>PMID: 32874365</identifier><language>eng</language><publisher>London, England: SAGE Publications</publisher><subject>Age ; Bone diseases ; Deformities ; Growth disorders ; Original Clinical ; Orthopedics ; Pediatrics ; Surgical techniques ; Teenagers</subject><ispartof>Journal of children's orthopaedics, 2020-08, Vol.14 (4), p.312-317</ispartof><rights>2020 European Pediatric Orthopaedic Society (EPOS), unless otherwise noted. Manuscript content on this site is licensed under Creative Commons Licenses.</rights><rights>Copyright © 2020, The author(s).</rights><rights>2020. This work is published under https://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Copyright © 2020, The author(s) 2020 The author(s)</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c474t-7ea4f1a3babb48240d89e7354a82d61f0995ae9e84a4aaf965aea8fdfb4151bd3</citedby><cites>FETCH-LOGICAL-c474t-7ea4f1a3babb48240d89e7354a82d61f0995ae9e84a4aaf965aea8fdfb4151bd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7453169/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7453169/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,21947,27834,27905,27906,44926,45314,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32874365$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Danino, Barry</creatorcontrib><creatorcontrib>Rödl, Robert</creatorcontrib><creatorcontrib>Herzenberg, John E.</creatorcontrib><creatorcontrib>Shabtai, Lior</creatorcontrib><creatorcontrib>Grill, Franz</creatorcontrib><creatorcontrib>Narayanan, Unni</creatorcontrib><creatorcontrib>Gigi, Roy</creatorcontrib><creatorcontrib>Segev, Eitan</creatorcontrib><creatorcontrib>Wientroub, Shlomo</creatorcontrib><title>The efficacy of guided growth as an initial strategy for Blount disease treatment</title><title>Journal of children's orthopaedics</title><addtitle>J Child Orthop</addtitle><description>Abstract
Purpose
The aim of this study was to evaluate the success of guided growth by temporal hemiepiphysiodesis of the lateral proximal tibia as a first line treatment option for Blount disease.
Methods
This was a retrospective multicentre study conducted in five centres, covering data on 55 limbs in 45 patients, with an average follow-up of 24.5 months following plate insertion. Preoperative alignment analysis was compared with three measurements taken postoperatively. The normalization of the mechanical medial proximal tibia angle (mMPTA) was defined as the primary outcome measure.
Results
Mean age at surgery was 9.5 years. Average preoperative mMPTA was 77°. On average, at 24.5 months post-surgery, mMPTA was 86.33°, while 43/55 limbs (78.18%) have achieved normalization (mMPTA 85° to 90°). Average rate of correction was 1° per month. When grouping the children as infantile (11 limbs), juvenile (12 limbs) and adolescent (32 limbs), operated on before the age of four years, between four and ten years and after the age of ten years, respectively, 63.63%, 66.67%, 87.5% have completed correction of deformity during the follow-up period. Interestingly, the femoral component of the deformity has achieved correction as well in 33/55 limbs (64%).
Conclusion
Hemiepiphysiodesis is an effective first line treatment for Blount disease. Overall success rate is good but varies according to child's age. Adolescent Blount has the best chance of achieving full correction while same treatment is less effective in infantile Blount.
Level of evidence: IV</description><subject>Age</subject><subject>Bone diseases</subject><subject>Deformities</subject><subject>Growth disorders</subject><subject>Original Clinical</subject><subject>Orthopedics</subject><subject>Pediatrics</subject><subject>Surgical techniques</subject><subject>Teenagers</subject><issn>1863-2521</issn><issn>1863-2548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>AFRWT</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><recordid>eNp9kU1r3DAQhkVJaNKkv6AQBLn0slt9WZYvhSb0IxAIhfQsxvbIq-C1UklO2H9fLZts0xx6Gs3omXdmeAn5wNmSSyY-caPlQlTKLLlaCsZYzd6Q4331YP8W_Ii8S-mOMc2axrwlR1KYWkldHZOftyuk6JzvoNvQ4Ogw-x57OsTwmFcUEoWJ-slnDyNNOULGYUNdiPRiDPOUae8TQkKaI0Je45RPyaGDMeH7p3hCfn37env5Y3F98_3q8sv1olO1yosaQTkOsoW2VUYo1psGa1kpMKLX3JVNK8AGjQIF4BpdMjCud63iFW97eUI-73Tv53aNfVdGRxjtffRriBsbwNt_fya_skN4sLWqJNdNEfj4JBDD7xlTtmufOhxHmDDMyQolGy2l1qag56_QuzDHqZxnRWWUrLnhdaHkjupiSCmi2y_Dmd1aZreG2K05liu7s6x0nb28Y9_z7FEB2A5IMODfwf_T_ANmo6DR</recordid><startdate>20200801</startdate><enddate>20200801</enddate><creator>Danino, Barry</creator><creator>Rödl, Robert</creator><creator>Herzenberg, John E.</creator><creator>Shabtai, Lior</creator><creator>Grill, Franz</creator><creator>Narayanan, Unni</creator><creator>Gigi, Roy</creator><creator>Segev, Eitan</creator><creator>Wientroub, Shlomo</creator><general>SAGE Publications</general><general>Sage Publications Ltd</general><general>The British Editorial Society of Bone & Joint Surgery</general><scope>AFRWT</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>NAPCQ</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20200801</creationdate><title>The efficacy of guided growth as an initial strategy for Blount disease treatment</title><author>Danino, Barry ; Rödl, Robert ; Herzenberg, John E. ; Shabtai, Lior ; Grill, Franz ; Narayanan, Unni ; Gigi, Roy ; Segev, Eitan ; Wientroub, Shlomo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c474t-7ea4f1a3babb48240d89e7354a82d61f0995ae9e84a4aaf965aea8fdfb4151bd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Age</topic><topic>Bone diseases</topic><topic>Deformities</topic><topic>Growth disorders</topic><topic>Original Clinical</topic><topic>Orthopedics</topic><topic>Pediatrics</topic><topic>Surgical techniques</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Danino, Barry</creatorcontrib><creatorcontrib>Rödl, Robert</creatorcontrib><creatorcontrib>Herzenberg, John E.</creatorcontrib><creatorcontrib>Shabtai, Lior</creatorcontrib><creatorcontrib>Grill, Franz</creatorcontrib><creatorcontrib>Narayanan, Unni</creatorcontrib><creatorcontrib>Gigi, Roy</creatorcontrib><creatorcontrib>Segev, Eitan</creatorcontrib><creatorcontrib>Wientroub, Shlomo</creatorcontrib><collection>Sage Journals GOLD Open Access 2024</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Nursing & Allied Health Premium</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of children's orthopaedics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Danino, Barry</au><au>Rödl, Robert</au><au>Herzenberg, John E.</au><au>Shabtai, Lior</au><au>Grill, Franz</au><au>Narayanan, Unni</au><au>Gigi, Roy</au><au>Segev, Eitan</au><au>Wientroub, Shlomo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The efficacy of guided growth as an initial strategy for Blount disease treatment</atitle><jtitle>Journal of children's orthopaedics</jtitle><addtitle>J Child Orthop</addtitle><date>2020-08-01</date><risdate>2020</risdate><volume>14</volume><issue>4</issue><spage>312</spage><epage>317</epage><pages>312-317</pages><issn>1863-2521</issn><eissn>1863-2548</eissn><abstract>Abstract
Purpose
The aim of this study was to evaluate the success of guided growth by temporal hemiepiphysiodesis of the lateral proximal tibia as a first line treatment option for Blount disease.
Methods
This was a retrospective multicentre study conducted in five centres, covering data on 55 limbs in 45 patients, with an average follow-up of 24.5 months following plate insertion. Preoperative alignment analysis was compared with three measurements taken postoperatively. The normalization of the mechanical medial proximal tibia angle (mMPTA) was defined as the primary outcome measure.
Results
Mean age at surgery was 9.5 years. Average preoperative mMPTA was 77°. On average, at 24.5 months post-surgery, mMPTA was 86.33°, while 43/55 limbs (78.18%) have achieved normalization (mMPTA 85° to 90°). Average rate of correction was 1° per month. When grouping the children as infantile (11 limbs), juvenile (12 limbs) and adolescent (32 limbs), operated on before the age of four years, between four and ten years and after the age of ten years, respectively, 63.63%, 66.67%, 87.5% have completed correction of deformity during the follow-up period. Interestingly, the femoral component of the deformity has achieved correction as well in 33/55 limbs (64%).
Conclusion
Hemiepiphysiodesis is an effective first line treatment for Blount disease. Overall success rate is good but varies according to child's age. Adolescent Blount has the best chance of achieving full correction while same treatment is less effective in infantile Blount.
Level of evidence: IV</abstract><cop>London, England</cop><pub>SAGE Publications</pub><pmid>32874365</pmid><doi>10.1302/1863-2548.14.200070</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1863-2521 |
| ispartof | Journal of children's orthopaedics, 2020-08, Vol.14 (4), p.312-317 |
| issn | 1863-2521 1863-2548 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7453169 |
| source | DOAJ Directory of Open Access Journals; Sage Journals GOLD Open Access 2024; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; Alma/SFX Local Collection |
| subjects | Age Bone diseases Deformities Growth disorders Original Clinical Orthopedics Pediatrics Surgical techniques Teenagers |
| title | The efficacy of guided growth as an initial strategy for Blount disease treatment |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-19T14%3A03%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20efficacy%20of%20guided%20growth%20as%20an%20initial%20strategy%20for%20Blount%20disease%20treatment&rft.jtitle=Journal%20of%20children's%20orthopaedics&rft.au=Danino,%20Barry&rft.date=2020-08-01&rft.volume=14&rft.issue=4&rft.spage=312&rft.epage=317&rft.pages=312-317&rft.issn=1863-2521&rft.eissn=1863-2548&rft_id=info:doi/10.1302/1863-2548.14.200070&rft_dat=%3Cproquest_pubme%3E2584371817%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2584371817&rft_id=info:pmid/32874365&rft_sage_id=10.1302_1863-2548.14.200070&rfr_iscdi=true |