Guided growth: mechanism and reversibility of modulation
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- 作者：Martin Gottliebsen ; Juan Manuel Shiguetomi-Medina…
- 关键词：Guided growth ; Growth plate ; Children ; Epiphysiodesis ; Deformities ; Leg length discrepancy
- 刊名：Journal of Children's Orthopaedics
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：10
- 期：6
- 页码：471-477
- 全文大小：623KB
- 刊物主题：Orthopedics; Pediatrics; Traumatic Surgery;
- 出版者：Springer Berlin Heidelberg
- ISSN：1863-2548
- 卷排序：10
文摘
In paediatric orthopaedics, deformities and discrepancies in length of bones are key problems that commonly need to be addressed in daily practice. An understanding of the physiology behind developing bones is crucial for planning treatment. Modulation of the growing bone can be performed in a number of ways. Here, we discuss the principles and mechanisms behind the techniques. Historically, the first procedures were destructive in their mechanism but reversible techniques were later developed with stapling of the growth plate being the gold standard treatment for decades. It has historically been used for both angular deformities and control of overall bone length. Today, tension band plating has partially overtaken stapling but this technique also carries a risk of complications. The diverging screws in these implants are probably mainly useful for hemiepiphysiodesis. We also discuss new minimally invasive techniques that may become important in future clinical practice.