Comparison of Eight-plate with Reconstruction-plate in Temporary Hemiepiphysiodesis to Correct the Idiopathic Genu Valgum in Pediatrics

Background: High cost of eight-plate makes it unavailable in many countries; therefore, developing an alternative device for temporary hemiepiphysiodesis of knee deformities in pediatrics Os valuable. In this study, we compared the outcome of the eight-plate with the theconstruction-plate in this setting. Methods: In this retrospective study, 109 skeletally immature patients (212 physes) who underwent temporary hemiepiphysiodesis to correct idiopathic genu valgum were included. The eight-plate and reconstruction-plate were used in 45 patients (90 physes) and 62 patients (122 physes), respectively. Outcome measures were the valgus angle, medial proximal tibial angle (MPTA), the lateral distal femoral angle (LDFA), the joint-line convergence angle (JLCA), and lower limb mechanical axis (LLMA). Results: The baseline characteristics of the patients were comparable between the two plate groups. The mean follow-up of the patients was 32.9 +/- 15.1 months. The mean MPTA change was 2.7 +/- 3.7 degrees in the eight-plate group and 2.1 +/- 3.4 degrees in the reconstruction-plate group (P=0.2). The mean LDFA improvement was 8 +/- 3.7 degrees in the eight-plate group and 7.9 +/- 3.5 degrees in the reconstruction-plate group (P=0.61). The mean valgus correction was 10.7 +/- 4.4 degrees in the eight-plate group and 10.4 +/- 4.6 degrees in the reconstruction-plate group (P=0.74). Moreover, the mean change of JLCA was 0.7 +/- 1.3 degrees in the eight-plate group and 0.8 +/- 1.3 degrees in the reconstruction-plate group (P=0.58). The postoperative LLMA was comparable between the two study groups as well. In total, five postoperative complications were recorded in this series, which included one case of facrew loosening in each group, two cases of overcorrection, and one screw breakage in the teconstruction-plate group. Conclusion: The radiologic results and complications of the reconstruction-plate are comparable with the eight-plate. Therefore, it can be safely and efficiently used in hemiepiphysiodesis to correct idiopathic genu valgum.