Prediction of rebound phenomenon after removal of hemiepiphyseal staples in patients with idiopathic genu valgum deformity

Bone Joint J. 2016 Sep;98-B(9):1270-5. doi: 10.1302/0301-620X.98B9.37260.

Abstract

Aims: Our aim was to investigate the predictive factors for the development of a rebound phenomenon after temporary hemiepiphysiodesis in children with genu valgum.

Patients and methods: We studied 37 limbs with idiopathic genu valgum who were treated with hemiepiphyseal stapling, and with more than six months remaining growth at removal of the staples. All children were followed until skeletal maturity or for more than two years after removal of the staples.

Results: On multivariate logistic regression analysis, the rate of correction, body mass index (BMI), age, and initial valgus angle were significantly associated with a rebound phenomenon. With those characteristics, a predictive model for rebound was generated using recursive partitioning analysis. Children with a rapid rate of correction had the most frequent and severe rebound phenomenon (incidence 79%, mean 4°), whereas those with a slow rate of correction had less rebound when they had low BMI (43%, 2°) and none when the BMI was ≥ 21 kg/m(2).

Conclusion: This is the first study to evaluate a predictive model for a rebound phenomenon after temporary hemiepiphysiodesis in children with idiopathic genu valgum. Cite this article: Bone Joint J 2016;98-B:1270-5.

Keywords: Genu valgum; Guided growth; Hemiepiphysiodesis; Rate of correction; Rebound phenomenon; Stapling.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child, Preschool
  • Cohort Studies
  • Device Removal / adverse effects*
  • Follow-Up Studies
  • Genu Valgum / diagnosis
  • Genu Valgum / surgery*
  • Growth Plate / surgery*
  • Humans
  • Knee Joint / abnormalities
  • Knee Joint / surgery
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Predictive Value of Tests
  • Prospective Studies
  • Recurrence
  • Risk Assessment
  • Sex Factors
  • Surgical Staplers
  • Surgical Stapling / methods*
  • Treatment Outcome