Dataset Information

Correction of rotational deformities in long bones using guided growth: a scoping review.

ABSTRACT:

Purpose

The objective of this scoping review was to describe the extent and type of evidence of using guided growth to correct rotational deformities of long bones in children.

Methods

This scoping review was conducted in accordance with the JBI methodology for scoping reviews. All published and unpublished studies investigating surgical methods using guided growth to perform gradual rotation of long bones were included.

Results

Fourteen studies were included: one review, three clinical studies, and ten preclinical studies. In the three clinical studies, three different surgical methods were used on 21 children. Some degree of rotation was achieved in all but two children. Adverse effects reported included limb length discrepancy (LLD), knee stiffness and rebound of rotation after removal of tethers. Of the ten preclinical studies, two were ex vivo and eight were in vivo. Rotation was achieved in all preclinical studies. Adverse effects reported included implant extrusions, LLD, articular deformities, joint stiffness and rebound of rotation after removal of tethers. Two of the studies reported on histological changes.

Conclusions

All studies conclude that guided growth is a potential treatment for rotational deformities of long bones. There is great variation in animal models and surgical methods used and in reported adverse effects. More research is needed to shed light on the best surgical guided growth method, its effectiveness as well as the involved risks and complications. Based on current evidence the procedure is still to be considered experimental.

Level of evidence

SUBMITTER: Halloum A

PROVIDER: S-EPMC10873243 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature

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Publications

Correction of rotational deformities in long bones using guided growth: a scoping review.

Halloum Ahmed A Kold Søren S Rölfing Jan Duedal JD Abood Ahmed A AA Rahbek Ole O

EFORT open reviews 20240201 2

<h4>Purpose</h4>The objective of this scoping review was to describe the extent and type of evidence of using guided growth to correct rotational deformities of long bones in children.<h4>Methods</h4>This scoping review was conducted in accordance with the JBI methodology for scoping reviews. All published and unpublished studies investigating surgical methods using guided growth to perform gradual rotation of long bones were included.<h4>Results</h4>Fourteen studies were included: one review, t ...[more]

PMID: 38308954

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Project description:IntroductionDeformities of the lower extremities can be congenital or acquired. Various surgical treatments have been employed for such disorders including osteotomy followed by either external fixation, internal fixation or external fixator assisted internal fixation. The aim of surgery is correction of deformity and restoration of mechanical axis and joint line. External fixator assisted internal fixation with intramedullary (IM) nail insertion is considered the gold standard, however, it is less commonly practiced as expertise required are usually not available at most centers. This study was conducted to assess the radiological and functional outcomes after fixator assisted IM nailing for correction of lower limbs deformity.MethodsIt was a retrospective study at a tertiary care hospital. All cases of lower limb deformity whose correction was done with fixator assisted IM nailing from 2010 till 2017 were analyzed. Pre Op x-rays and post op x rays were analyzed for Mechanical Axis Deviation (MAD), anatomical Lateral Distal Femoral Angle (aLDFA), mechanical Lateral Distal Femoral Angle (mLDFA) and Medial Proximal Tibial Angle (MPTA), post-operative activity and functional status of the patients. Data was analyzed using SPSS.ResultsThirteen patients were included in the study. Fixator assisted IM nailing was performed on 29 long bones of these patients including 16 femur and 13 tibial deformities. Pre Op and Post Op comparison was done for MAD, aLDFA, mLDFA, MPTA. Pre op mean MAD was 38.87 ± 25.58 post op mean MAD 17.54 ± 12.25 mm. Only 2 of our patients developed knee stiffness for which manipulation under anesthesia was done. One of our patients developed weakness in toe extension, which recovered after 6 months. On follow up evaluation patients had normal range of motion and no functional limitation.ConclusionFixator assisted IM nailing for deformity correction is a better option, because it has advantages of both external fixator and internal fixator. Knee stiffness associated with external fixator can be prevented. It is more convenient for patient.

Dataset Information

Correction of rotational deformities in long bones using guided growth: a scoping review.

Purpose

Methods

Results

Conclusions

Level of evidence

Publications

Correction of rotational deformities in long bones using guided growth: a scoping review.

Similar Datasets

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