Document Detail


Mechanical failures of eight-plateguided growth system for temporary hemiepiphysiodesis.
MedLine Citation:
PMID:  20733426     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: For decades, the Blount staple has been used to perform temporary hemiepiphysiodesis for angular deformity correction in children with open growth plates. Recently, the eight-PlateGuided Growth System (Orthofix, McKinney, TX) has gained popularity for use in this procedure. The eight-Plate is said to be superior to the Blount staple, as it is less likely to break or migrate out of the bone. However, some centers have observed mechanical failures of the eight-Plate cannulated screws.
METHODS: The purpose of our study was to conduct a multicenter survey to determine which factors increase the risk of mechanical failure with this device. We distributed a questionnaire in 2007 to 841 members of the Pediatric Orthopaedic Society of North America that asked about their experience with the eight-Plate and whether they had observed any mechanical failures. Follow-up surveys were distributed to determine the background of the failed cases.
RESULTS: Of the 445 (53%) surgeons who responded, 314 (71%) reported that they use the eight-Plate in their practice. Forty-eight (15%) of the 314 surgeons who use the eight-Plate observed a total of 65 cases of mechanical failure. In every case, the screws failed, not the plate. The average body mass index of these patients was 37.8 kg/m (range, 19.2 to 70.2 kg/m).
CONCLUSIONS: Overweight and obese patients with Blount disease were among those most likely to experience eight-Plate screw failure. Fractures occurred almost always in the metaphyseal screw-not where the head meets the shank but where the shank enters the lateral cortex, presumably because of 3-point bending. No broken plates were reported. In high-risk cases, we now consider using 2 parallel eight-Plates or using solid (not cannulated) screws for plate fixation.
LEVEL OF EVIDENCE: Level IV.
Authors:
Rolf D Burghardt; Stacy C Specht; John E Herzenberg
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  30     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-24     Completed Date:  2010-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  594-7     Citation Subset:  IM    
Affiliation:
International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Bone Diseases, Developmental / complications
Bone Plates
Bone Screws*
Child
Child, Preschool
Epiphyses / abnormalities,  surgery
Equipment Failure*
Female
Follow-Up Studies
Growth Plate / abnormalities,  surgery*
Humans
Knee Joint / abnormalities,  surgery
Male
Obesity / complications
Orthopedic Procedures / methods*
Osteochondrosis / complications,  congenital
Overweight / complications
Questionnaires
Risk Factors
Surgical Stapling / methods
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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