Angular Deformity Correction by Asymmetrical Physeal Supression in Children / 대한정형외과학회잡지

ABSTRACT

Angular deformity of extremities in children and adolescents with residual growth is not a rare condition in orthopaedics. Asymmetrical physeal suppression or guided growth method, one of the surgical techniques for correction of angular deformity, is a method of inducing plastic deformation by application of constant external force to a growing bone. Internal fixation devices used for asymmetrical physeal suppression include staples, transphyseal screws, and tension band plates, most representatively the 8-plate. Temporary hemiepiphysiodesis using staples is reported to show a success rate of 60% to 80%. Epiphysiodesis using transphyseal screws has several advantages over staples or 8-plates; smaller skin incision, shorter operation time, no postoperative splint or cast, faster return to daily life. Advantages of 8-plates over staples or transphyseal plates include a longer moment arm, which enables better correction of angular deformity and less suppression of the growth of the nearby normal growth plate. Asymmetrical physeal suppression is a simple and effective surgical method in correcting angular deformity of extremities of children and adolescents. Each of three internal fixation devices discussed in the current article has strengths and weaknesses and superiority in terms of angular correction power and complication rate, however further study is needed. Therefore, the most appropriate device should be selected according to the condition of each patient.