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Abstract
Background In children with angulating deformities of the lower limbs, hemiepiphysiodesis can be used to guide growth to achieve better alignment at skeletal maturity. Traditionally, this has been performed with staples. The tension-band plating technique is new and it has been advocated because it is believed to reduce the risk of premature closure of the growth plate compared to stapling. The benefit of the tension-band plating technique has not yet been proven in experimental or randomized clinical studies.
Methods We performed a randomized clinical trial in which 26 children with idiopathic genu valgum were allocated to stapling or tension-band plating hemiepiphysiodesis. Time to correction of the deformity was recorded and changes in angles on long standing radiographs were measured. Pain score using visual analog scale (VAS) was recorded for the first 72 h postoperatively. Analgesics taken were recorded by the parents.
Results Mean treatment times for stapling hemiepiphysiodesis (n = 10) and for tension-band plating hemiepiphysiodesis (n = 10) were similar. Postoperative VAS scores and consumption of analgesics were also similar in both groups. No hardware failure or wound-related infection was observed.
Interpreatation Treatment time for the 2 treatment modalities was not significantly different in this randomized clinical trial. Tension-band plating and stapling appeared to have a similar effect regarding correction of genu valgum. We cannot rule out type-II error and the possibility that our study was underpowered.
ClinicalTrials.gov Identifier: NCT01641354.
MG, OR, IH, MD, MBH, and BMM designed the study. MG and OR collected the data. MG analyzed the data. MG wrote the draft manuscript. OR, IH, MD, MBH, and BMM ensured the accuracy of the data and analyses and approved the final version of the manuscript before submission.
The trial was supported by the Institute of Clinical Medicine, Aarhus University and the Central Denmark Region. No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
No competing interests declared.