Growth Modulation

DESCRIPTION

Deformities or weakness in the legs can cause inhibited growth, abnormality in walking and functional limitations in individuals. In the growth modulation with eight-plate procedure an “8” shaped plate about the size of a paper clip is implanted to correct limb deformities in children from the age of 18 months until the end of the growth years (approximately age 13 to 17). The device facilitates gradual correction of limb alignment promoting natural and safe growth.

CONDITIONS TREATED

  • Ankle valgus
  • Cubitus varus
  • Knee flexion deformity
  • Knee oblique plane
  • Knee recurvatum
  • Knee valgus
  • Knee varus

PROCEDURE

During the implantation procedure, a pin is inserted into the growth plate and the position is verified with a fluoroscope (live X-ray). The eight-plate device is then applied over the pin.

An epiphyseal guide wire and metaphyseal guide wire are inserted one after the other using a drill guide (but avoiding the physis). Two 5cm holes are created with a drill bit; they do not need to be parallel but should be proximal and distal to the physis. Self-taping screws are then inserted into the holes to hold the eight-plate in position. The guide wires are carefully removed at the end of the procedure.

The eight-plate with screws effectively serves as a hinge, preventing compression of the growth plate and enabling normal bone growth. The eight-plate’s flexibility prevents it from bending or breaking from the forces of bone growth.

ADVANTAGES

  • Minimally invasive technique
  • Flexible implanted device
  • A simple outpatient procedure
  • Immediate mobilization
  • Minimal post-operative pain
  • No casting required

Sources

  1. Growth Plate Injuries. (2011, October) NIAMS.NIH.gov. Retrieved on July 29, 2014, from http://www.niams.nih.gov/Health_info/Growth_Plate_Injuries/default.asp
  2. Guided Growth System. (n.d.). Orthofix.com. Retrieved on July 29, 2014, from http://us.orthofix.com/products/eight-plate2.asp?cid=8
  3. Goldman, V., & Green, D. (2010) Advances in Growth Plate Modulation for Lower Extremity Malalignment (Knock Knees and Bow Legs). Current Opinion in Pediatrics, 2010(22) 47–53. Retrieved on July 29, 2014, from http://jsevro.de/downloads/Studie%20Hinge%20Plate.pdf