2019, Number 1-3
<< Back Next >>
Rev Mex Ortop Ped 2019; 21 (1-3)
Guided growth in pediatric patients with post-amputation transtibial varus deformity
Masquijo JJ, Allende V
Language: Spanish
References: 10
Page: 22-25
PDF size: 127.30 Kb.
ABSTRACT
Angular deformities are common in patients with transtibial amputations. Although the initial management usually consists in the modification of the prosthesis, more severe or progressive deformities usually require surgical treatment. We report two cases (skeletally immature patients) who received transtibial amputation and subsequently developed progressive varus deformity. This prevented from adapting correctly to the prosthetic socket and caused pain and difficulty in walking. Both patients were treated by guided growth with the placement of eight-plates in the proximal lateral tibia. The normalization of the mechanical axis allowed to relieve pain, a better prosthesis fitting as well as a walking improvement. The use guided growth as an alternative to the osteotomy produces a lower morbidity and allows the use of the prosthesis while the correction is obtained.
REFERENCES
Segal LS, Crandall RC. Tibia vara deformity after below knee amputation and synostosis formation in children. J Pediatr Orthop. 2009; 29(2): 120-123.
Stevens PM. Guided growth for angular correction: a preliminary series using a tension band plate. J Pediatr Orthop. 2007; 27: 253-259.
Growth modulation for coronal deformity correction by using Eight Plates-Systematic review. J Orthop. 2018; 15(1): 168-172.
Gyr BM, Colmer HG 4th, Morel MM, Ferski GJ. Hemiepiphysiodesis for correction of angular deformity in pediatric amputees. J Pediatr Orthop. 2013; 33(7): 737-742.
Sakkers R, van Wijk I. Amputation and rotationplasty in children with limb deficiencies: current concepts. J Child Orthop. 2016; 10(6): 619-626.
Firth GB, Masquijo JJ, Kontio K. Transtibial Ertl amputation for children and adolescents: a case series and literature review. J Child Orthop. 2011; 5(5): 357-362.
Beals RK, Skyhar M. Growth and development of the tibia, fibula and ankle joint. Clin Orthop Relat Res. 1984; 182: 289-292.
Wright JM, Crockett HC, Slawski DP et al. High tibial osteotomy. J Am Acad Orthop Surg. 2005; 13: 279-289.
Tourn D, Lanfranchi L, Allende V, Masquijo JJ. Crecimiento guiado con placas en 8 para la corrección de deformidades angulares en pacientes esqueléticamente inmaduros. Rev Asoc Argent Ortop Traumatol. 2015; 80(4): 254-259.
McCarthy JJ, Burke T, McCarthy MC. Need for concomitant proximal fibular epiphysiodesis when performing a proximal tibial epiphysiodesis. J Pediatr Orthop. 2003; 23(1): 52-54.
Full text