Introduction

Tension band plates (TBP) for guided growth (GG) are the gold standard treatment for angular deformities around the knee. EPIFLEX® is a novel flexible TBP that adjusts to the patient's bone anatomy.

Hypothesis

GG using a flexible TBP produces satisfactory correction rates with minor complications in the pediatric population with angular deformities around the knee.

Materials and methods

A retrospective evaluation of 33 patients (60 knees) treated for genu varum and valgum with hemiepiphysiodesis using a flexible TBP between 2017 and 2020 was performed. The study aimed to assess correction and complication rates; patients who completed treatment were included regardless of the follow-up times after implant removal.

Results

Thirteen females and 20 males with a median age of 10 years were included. The median treatment duration and follow-up were 10 and 22 months. The median monthly rate of change of mLDFA and mMPTA was 0.67° and 0.57°, respectively. A successful correction was achieved in 90% of the cases. There were no cases of infection or implant failure. Four cases presented overcorrection and two undercorrection; no significant relation with deformity or obesity was found.

Discussion

GG using this flexible TBP showed satisfactory correction rates with a low incidence of complications and no implant failure. It provides flexibility through good adaptability to the bone anatomy and mobility of the screws avoiding implant protrusion or breakage.

Level of evidence

IV; observational descriptive case series.

中文翻译：

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使用新型柔性板系统通过引导生长矫正小儿下肢成角畸形

介绍

用于引导生长 (GG) 的张力带板 (TBP) 是治疗膝关节周围成角畸形的金标准。EPIFLEX® 是一种新型灵活的 TBP，可根据患者的骨骼解剖结构进行调整。

假设

GG 使用灵活的 TBP 在膝关节周围有角畸形的儿科人群中产生令人满意的矫正率和轻微并发症。

材料和方法

对 2017 年至 2020 年期间使用灵活的 TBP 进行膝内翻和外翻治疗的 33 名患者（60 膝）进行了回顾性评估。该研究旨在评估矫正率和并发症发生率；无论植入物移除后的随访时间如何，完成治疗的患者都包括在内。

结果

包括 13 名女性和 20 名男性，中位年龄为 10 岁。中位治疗持续时间和随访时间分别为 10 个月和 22 个月。mLDFA 和 mMPTA 的月平均变化率分别为 0.67° 和 0.57°。在 90% 的案例中实现了成功的纠正。没有感染或植入失败的病例。4例过矫2例欠矫；未发现与畸形或肥胖有显着关系。

讨论

使用这种灵活的 TBP 的 GG 显示出令人满意的矫正率，并发症发生率低且没有植入失败。它通过对骨骼解剖学的良好适应性和螺钉的移动性提供灵活性，避免植入物突出或破损。

证据等级

四；观察性描述性病例系列。