Clinical Experience with Epiphyseal Stapling

ABSTRACT

For the correction of leg length discrepancy in children, epiphyseal stapling was done for 41 epiphyses on 25 cases. The time of the stapling operation was chosen by using the chart of Green and Anderson, so that the leg length would be equal automatically at the end of epiphyseal bone growth. In this way an operation to remove the staples according to Blount's method was eliminated, an operation which usually injures the epiphyseal cartilage and often results in angular deformities. Also it eliminated the fear of retarding or stopping epiphyseal bone growth after holding the epiphyseal plate by staples for a long period. All 3/64 inch and some of the 5/64 inch rod staples were broken, and the rest of the 5/64 inch rod staples were widely open. Therefore, in the later period of this experiment, the authors used three period of this experiment, the authors used three 7/64 inch rod staples as a unit. Because the staples are to resist continuously the tremendous growing power of the epiphysis, danger always exists until growth ceases. Therefore, selecting staples with adequate strength and conducting close follow-up studies at frequent intervals are very important in preventing complications. In the average period of observation of 3 years and 2 months, the average discrepancy of leg length was decreased from 6.5cm to 2.3cm instead of the gradual increase that occurs in untreated cases.