Percutaneous Epiphysiodesis

Kim, Sung Joon; Whang, Kuhn Sung; Ha, Tae Seoung; Park, Hee Cheul

Abstract

Leg length discrepancy in the growing children was developed by multiple causes; such as congenital, infection, traumatic, and mechanical facotrs etc. The discrepancy have been treated by several methods including bony lengthening which is preferable method, but epiphysiodesis also has been one of the valuable methods in which was applied to the treatment of mild to moderate leg length discrepancy in the growing children. We report on patients(15 cases) with leg length discrepancy treated by percutaneous epiphysiodesis since July 1986. There were 8 males and 7 females and the average age of them was 12.6 years old. And we also performed an experimental study which was to find out the effectiveness of the pereutaneous physeal destruction comparing the techningues between curette and drill in the bony models. The causes of leg length discrepancy were trauma in 8 cases and osteomyelitis in 2 cases, congenital dislocation of the hip in 2 cases, poliomyelitis, Legg-Galve-Perthes disease, congenital hemihypertropy in each 1 case. The average preoperative leg length discrepancy was 2.6cm(range:1.9-3.7cm), and average anticipated discrepancy without operation have been 3.7cm(range:2.2-6.3cm) at maturity. The final discrepancy was 0.9cm after 43 months follow-up. According to the result by experimental study, percutaneous epiphysiodesis with curette technique would be more effective and safe than drill thchnique. Percutaneous epiphysiodesis might be one of the useful methods for the treatment of mild to moderate degree of leg length discrepancy in the growing children, and also could be applied combining with bony lengthening for treatment of severe degree of leg length discrepancy.