Functional and anatomical outcomes of 8-plate fixation in angular deformities of knee in children

Author(s): Dr. Shamnu P1, Dr. Aneen N Kutty2, Dr. Nithin Karun3, Dr. Manoj Kumar CV3
1Consultant Orthopaedician, Ceeyam hospital, Vatakara, Kerela, India.
2Professor of Orthopaedics, Calicut Medical College, India.
3Assistant Professor in Orthopaedics, Calicut Medical College, India.
Copyright © Dr. Shamnu P, Dr. Aneen N Kutty, Dr. Nithin Karun, Dr. Manoj Kumar CV. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Angular deformities of knee in children are a commonly encountered condition in orthopedic practice. Many of the cases are physiological and do not warrant any treatment.
Aim:To assess the functional and anatomical outcome of 8-plate fixation for genu valgum or genu varum deformities in children.
Material and Methods: The study was designed as a prospective and retrospective hospital based study in Dept. of Orthopedics, Govt. Medical College, Kozhikode. Patients attending the Orthopedic outpatient department at Govt. Medical College, Kozhikode between 1/6/2017 to 31/3/2019. Sample size was found to be 24. SPSS was used for analysis.
Results: Out of the 24 cases, 3 were implanted at age < 10 years. Median age at intervention was 13 years. Average age at intervention was 12.25 with a range of 9 years to 14 years. The following results were observed after following up a total of 24 patients who has undergone 8-plate fixation for angular deformities of knee. 15 were boys and 9 were girls. 18 were having valgus deformity and 6 were having varus deformity. In total 39 limbs and 56 physis were intervened. Mean period for implant removal is more when only tibia is implanted and least when both tibia and femur are implanted. However, this can’t be used to compare the efficacy of different implanting sites, as removal of implant is influenced by several factors like follow up visits and severity of primary deformity. More reliable measurement is the rate of correction of deformity.
Conclusion: In our study, we were able to demonstrate that hemiepiphysiodesis using eight plate is an effective and safe treatment for angular deformities of knee in children irrespective of the age group, sex and primary deformity. The rate of correction of deformity decreases as the age increases. So, early surgery is advisable in diagnosed pathological deformities. A proper follow up of the treated patients is needed to assess the response.

Keywords: Angular Deformities; Valgus; Varus; Plate fixation; Osteotomy.