Rebound phenomenon and its risk factors after hemiepiphysiodesis using tension band plate in children with coronal angular deformity
Abstract Background This study was performed to evaluate the rebound phenomenon after the correction of coronal angular deformity by hemiepiphysiodesis using tension band plate in children and to identify its risk factors. Methods We reviewed 50 children (mean age, 11.0 ± 2.5 years) with 94 physes w...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-022-05310-z |
| _version_ | 1819210140412280832 |
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| author | Kug Jin Choi Sanghoon Lee Moon Seok Park Ki Hyuk Sung |
| author_facet | Kug Jin Choi Sanghoon Lee Moon Seok Park Ki Hyuk Sung |
| author_sort | Kug Jin Choi |
| collection | DOAJ |
| description | Abstract Background This study was performed to evaluate the rebound phenomenon after the correction of coronal angular deformity by hemiepiphysiodesis using tension band plate in children and to identify its risk factors. Methods We reviewed 50 children (mean age, 11.0 ± 2.5 years) with 94 physes who had undergone hemiepiphysiodesis using tension band plate due to coronal angular deformity of the lower limb. Patients’ demographic data including sex, age at initial surgery and plate removal, affected bone (distal femur or proximal tibia), affected side, and body mass index were collected. The mechanical lateral distal femoral angle (mLDFA) and the mechanical medial proximal tibial angle (mMPTA) were measured from the teleradiogram, Physes were divided into rebound and non-rebound group, and rebound group was defined as the physes which had ≥ 5° of mLDFA or mMPTA returning to its original deformity. Generalized estimating equation based multivariable analysis was used to identify the risk factors for the rebound phenomenon after the deformity correction. Results A total of 41 physes classified into rebound group and 53 physes into non-rebound group. There were significant differences in the age at initial surgery (p = 0.004), the age at implant removal (p = 0.002), the amount of correction (p = 0.001), and the rate of correction (p < 0.001) between two groups. The rate of correction was significantly associated with the rebound phenomenon (p = 0.044). The risk of rebound phenomenon was 1.2-fold higher as the rate of correction increased by 1° per year. The cutoff values of the correction rate between the two groups were 6.9°/year (p < 0.001). Conclusions This study showed that the rebound group had younger age and faster correction rate than those in the non-rebound group. In addition, the correction rate for deformity was a significant risk factor for the rebound phenomenon after hemiepiphysiodesis using the tension band plate. Close monitoring after implant removal is required for children who have a rapid correction rate over 7°/year. |
| first_indexed | 2024-12-23T06:06:27Z |
| format | Article |
| id | doaj.art-b7e5e63af539453eb548a6d476cc6ee5 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-23T06:06:27Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-b7e5e63af539453eb548a6d476cc6ee52022-12-21T17:57:33ZengBMCBMC Musculoskeletal Disorders1471-24742022-04-012311810.1186/s12891-022-05310-zRebound phenomenon and its risk factors after hemiepiphysiodesis using tension band plate in children with coronal angular deformityKug Jin Choi0Sanghoon Lee1Moon Seok Park2Ki Hyuk Sung3Department of Orthopaedic Surgery, Seoul Now HospitalDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang HospitalDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang HospitalDepartment of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul National University Bundang HospitalAbstract Background This study was performed to evaluate the rebound phenomenon after the correction of coronal angular deformity by hemiepiphysiodesis using tension band plate in children and to identify its risk factors. Methods We reviewed 50 children (mean age, 11.0 ± 2.5 years) with 94 physes who had undergone hemiepiphysiodesis using tension band plate due to coronal angular deformity of the lower limb. Patients’ demographic data including sex, age at initial surgery and plate removal, affected bone (distal femur or proximal tibia), affected side, and body mass index were collected. The mechanical lateral distal femoral angle (mLDFA) and the mechanical medial proximal tibial angle (mMPTA) were measured from the teleradiogram, Physes were divided into rebound and non-rebound group, and rebound group was defined as the physes which had ≥ 5° of mLDFA or mMPTA returning to its original deformity. Generalized estimating equation based multivariable analysis was used to identify the risk factors for the rebound phenomenon after the deformity correction. Results A total of 41 physes classified into rebound group and 53 physes into non-rebound group. There were significant differences in the age at initial surgery (p = 0.004), the age at implant removal (p = 0.002), the amount of correction (p = 0.001), and the rate of correction (p < 0.001) between two groups. The rate of correction was significantly associated with the rebound phenomenon (p = 0.044). The risk of rebound phenomenon was 1.2-fold higher as the rate of correction increased by 1° per year. The cutoff values of the correction rate between the two groups were 6.9°/year (p < 0.001). Conclusions This study showed that the rebound group had younger age and faster correction rate than those in the non-rebound group. In addition, the correction rate for deformity was a significant risk factor for the rebound phenomenon after hemiepiphysiodesis using the tension band plate. Close monitoring after implant removal is required for children who have a rapid correction rate over 7°/year.https://doi.org/10.1186/s12891-022-05310-zCoronal angular deformityHemiepiphysiodesisTension-band plateRebound phenomenonCorrection rate |
| spellingShingle | Kug Jin Choi Sanghoon Lee Moon Seok Park Ki Hyuk Sung Rebound phenomenon and its risk factors after hemiepiphysiodesis using tension band plate in children with coronal angular deformity BMC Musculoskeletal Disorders Coronal angular deformity Hemiepiphysiodesis Tension-band plate Rebound phenomenon Correction rate |
| title | Rebound phenomenon and its risk factors after hemiepiphysiodesis using tension band plate in children with coronal angular deformity |
| title_full | Rebound phenomenon and its risk factors after hemiepiphysiodesis using tension band plate in children with coronal angular deformity |
| title_fullStr | Rebound phenomenon and its risk factors after hemiepiphysiodesis using tension band plate in children with coronal angular deformity |
| title_full_unstemmed | Rebound phenomenon and its risk factors after hemiepiphysiodesis using tension band plate in children with coronal angular deformity |
| title_short | Rebound phenomenon and its risk factors after hemiepiphysiodesis using tension band plate in children with coronal angular deformity |
| title_sort | rebound phenomenon and its risk factors after hemiepiphysiodesis using tension band plate in children with coronal angular deformity |
| topic | Coronal angular deformity Hemiepiphysiodesis Tension-band plate Rebound phenomenon Correction rate |
| url | https://doi.org/10.1186/s12891-022-05310-z |
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