Naslov
Multicenter Series of Deformity Correction using Guided Growth in the Setting of Osteogenesis Imperfecta.

Autori
Franzone, Jeanne ; Wallace, Maegan ; Rogers, Kenneth ; Strudthoff, Elizabeth ; Kruse Richard ; Antičević Darko.

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, prošireni sažetak, znanstveni

Izvornik
Final Virtual POSNA Programme / Sankar, Wudbhav. - Dallas (TX) : POSNA, 2021, 82-82

Skup
Hybrid Annual Meeting: Pediatric Orthopedic Society of North America (POSNA)

Mjesto i datum
Dallas (TX), Sjedinjene Američke Države, 12.05.2021. - 15.05.2021

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
osteogenesis imperfecta ; guided growth ; multicenter series

Sažetak
Purpose The mainstay of deformity correction and fracture prevention for patients with osteogenesis imperfecta (OI) includes osteotomies and intramedullary rodding. Guided growth offers a less invasive means of deformity correction and has been described in the setting of skeletal dysplasias. Our purpose is to report a multicenter series of guided growth procedures in the setting of OI. Methods A retrospective review of OI patients at three institutions from April 2012-April 2019 identified patients who underwent guided growth for angular deformity correction with minimum one year follow-up or full deformity correction and removal of the guided growth hardware. Clinical characteristics, deformity measurements and complications were collected. Distal femur and proximal tibial hemiepiphysiodeses were performed using figure- of-eight plates and screws ; distal tibial medial hemiepiphysiodeses were performed using cannulated screws. Preoperative and postoperative joint angle measurements included the lateral distal femoral angle (LDFA), medial proximal tibia angle (MPTA) and lateral distal tibial angle (LDTA). Results Fifteen OI patients (average age 11.8 years, range 6.5-16.3, 11 males, 4 females) underwent 30 guided growth procedures with a mean follow- up of 3.3 years (SD 1.8). OI Types included: I- 5, III-3, IV-4, V-3. All patients received routine bisphosphonate treatment. Preoperative and postoperative mean joint angles include: 8 distal femur medial hemiepiphysiodesis (83.5°, 88.3°), 2 distal femur lateral hemiepiphysiodesis (95.2°, 89.5°), 7 proximal tibial medial hemiepiphysiodesis (95.3°, 91.1°), 3 proximal tibial lateral hemiepiphysiodesis (84.0°, 92.3°), 10 distal tibia medial hemiepiphysiodesis (73.3°, 83.9°). For the distal femur and proximal tibial guided growth procedures, the mean change in mechanical axis deviation was 25.2mm (SD 30.1). Twelve of the 30 (40.0%) procedures were performed in the setting of an intramedullary rod. One patient demonstrated backout of the epiphyseal and metaphyseal screws of a distal femoral medial figure-of-eight plate. It was revised to a larger plate with longer screws and removed upon completion of deformity correction. Conclusion Guided growth may be used as an effective means of angular deformity correction with dysplastic OI bone. In this series, presence of an intramedullary rod did not preclude the use of a guided growth technique. To date, one of the 30 procedures demonstrated screw backout. Given the short stature associated with OI, consideration may be given to perform a guided growth procedure at an early enough age to allow time for correction. Significance To our knowledge, this is the first multicenter series reporting the efficacy of guided growth in OI patients.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA