Hemiepiphysiodesis: similar treatment time for tension-band plating and for stapling

Figures & data

Table 1. Pain-control regime

	Weight < 40 kg	Weight > 40 kg
Before surgery
Paracetamol	10 mg/kg	1 g
Ibuprofen	10 mg/kg	0.4 g
Soft tissue infiltration
Bupivacaine 5 mg/mL
+ adrenalin 5 µg/mL	0.5 mL/kg	0.5 mL/kg
Postoperatively
Paracetamol	10 mg/kg × 4	1 g × 4
Ibuprofen	10 mg/kg × 3	0.4 g × 3
Supple. morphine	0.2–0.4 mg/kg	0.2–0.4 mg/kg

A. Genu valgum prior to medial stapling of the distal femoral physes.

B. Before removal of implants.

C. Genu valgum prior to medial hemiepiphysiodesis of the distal femoral physes using the tension-band plating technique.

D. Correction of genu valgum before removal of implants.

Table 2. Treatment times and measurements of IM distance. Values are mean (CI)

	Tension-band plating	Stapling	p-value
Treatment time (days)	340 (286–394)	349 (263–435)	0.8
Preoperative IM (mm)	95 (78–111)	92 (82–102)	0.7
Final IM (mm)	–2 (–6 to 3)	–3 (–8 to 2)	0.6

Table 3. Radiographic measurements on long standing radiographs. Mean values between the left and right side are given. Values are mean (CI). Negative MAD values describe lateral deviation of the mechanical axis (valgus) and positive values describe medial deviation of the mechanical axis (varus)

	Tension-band plating	Stapling	p-value
Before surgery
LDFA (dgr)	85.5 (84–87)	85.7 (84–87)	0.8
MPTA (dgr)	89.8 (88–92)	90 (89–91)	0.9
MAD (mm)	–13 (– 18 to –8)	–12.2 (–20 to –5)	0.8
After surgery
LDFA (dgr)	92 (90–95)	94 (92–96)	0.4
MPTA (dgr)	90 (88–96)	92 (91–93)	0.2
MAD (mm)	10 (3–15)	10 (1–18)	1