Complications and errors in guided growth surgery
Objectives: Guided growth (GG) is a widely used treatment option in growing children with varus/valgus deformities (VVD) or limb length discrepancy (LLD). The outcomes of these different techniques have been widely reported. There is, however, a paucity of reports addressing adverse events (AEs) of...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2023-01-01
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| Series: | Journal of Limb Lengthening & Reconstruction |
| Subjects: | |
| Online Access: | http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2023;volume=9;issue=2;spage=70;epage=81;aulast=Burghardt |
| _version_ | 1797221316150951936 |
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| author | Rolf D Burghardt Kevin von der Heydt Natascha Heckel John E Herzenberg Rainer Burgkart |
| author_facet | Rolf D Burghardt Kevin von der Heydt Natascha Heckel John E Herzenberg Rainer Burgkart |
| author_sort | Rolf D Burghardt |
| collection | DOAJ |
| description | Objectives: Guided growth (GG) is a widely used treatment option in growing children with varus/valgus deformities (VVD) or limb length discrepancy (LLD). The outcomes of these different techniques have been widely reported. There is, however, a paucity of reports addressing adverse events (AEs) of GG. We reviewed the clinical results of GG for VVD or LLD with an emphasis on describing AE. Methods: AEs were collected and analyzed for all cases treated at a single European institution with GG for VVD or LLD. AEs were classified into five categories: improper indications, malpositioned implants, errors in timing of hardware removal, general surgical complications, and implant failures/incomplete removals. Results: During the defined time period, 117 patients for LLD and 106 patients were operated for VVD. In total, there were 111 AEs (LLD = 60, VVD = 51). These were subdivided into categories: improper indications (31) (LLD = 20, VVD = 11), malpositioned implants (26) (LLD = 23, VVD = 3), errors in timing of hardware removal (25) (LLD = 9, VVD = 16), general surgical complications (20) (LLD = 5, VVD = 15), and implant failures/incomplete removals (9) (LLD = 3, VVD = 6). Conclusions: Most AEs can be avoided through correct radiological analysis of limb alignment and a basic understanding of the principles of GG. Furthermore, it is essential to place the implant precisely and ensure regular follow-up evaluations. While ostensibly a simple procedure, therapeutic decisions regarding planning of GG need to be thoughtfully made, the actual performance of the GG surgery should not be relegated to an under-supervised junior team member. Careful follow-up is imperative. |
| first_indexed | 2024-04-24T13:03:30Z |
| format | Article |
| id | doaj.art-e44852de57894362be40204d9f158c38 |
| institution | Directory Open Access Journal |
| issn | 2455-3719 |
| language | English |
| last_indexed | 2024-04-24T13:03:30Z |
| publishDate | 2023-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Limb Lengthening & Reconstruction |
| spelling | doaj.art-e44852de57894362be40204d9f158c382024-04-05T10:13:57ZengWolters Kluwer Medknow PublicationsJournal of Limb Lengthening & Reconstruction2455-37192023-01-0192708110.4103/jllr.jllr_13_22Complications and errors in guided growth surgeryRolf D BurghardtKevin von der HeydtNatascha HeckelJohn E HerzenbergRainer BurgkartObjectives: Guided growth (GG) is a widely used treatment option in growing children with varus/valgus deformities (VVD) or limb length discrepancy (LLD). The outcomes of these different techniques have been widely reported. There is, however, a paucity of reports addressing adverse events (AEs) of GG. We reviewed the clinical results of GG for VVD or LLD with an emphasis on describing AE. Methods: AEs were collected and analyzed for all cases treated at a single European institution with GG for VVD or LLD. AEs were classified into five categories: improper indications, malpositioned implants, errors in timing of hardware removal, general surgical complications, and implant failures/incomplete removals. Results: During the defined time period, 117 patients for LLD and 106 patients were operated for VVD. In total, there were 111 AEs (LLD = 60, VVD = 51). These were subdivided into categories: improper indications (31) (LLD = 20, VVD = 11), malpositioned implants (26) (LLD = 23, VVD = 3), errors in timing of hardware removal (25) (LLD = 9, VVD = 16), general surgical complications (20) (LLD = 5, VVD = 15), and implant failures/incomplete removals (9) (LLD = 3, VVD = 6). Conclusions: Most AEs can be avoided through correct radiological analysis of limb alignment and a basic understanding of the principles of GG. Furthermore, it is essential to place the implant precisely and ensure regular follow-up evaluations. While ostensibly a simple procedure, therapeutic decisions regarding planning of GG need to be thoughtfully made, the actual performance of the GG surgery should not be relegated to an under-supervised junior team member. Careful follow-up is imperative.http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2023;volume=9;issue=2;spage=70;epage=81;aulast=Burghardtcomplicationeight plateguided growthhardware failurehemiepiphysiodesis |
| spellingShingle | Rolf D Burghardt Kevin von der Heydt Natascha Heckel John E Herzenberg Rainer Burgkart Complications and errors in guided growth surgery Journal of Limb Lengthening & Reconstruction complication eight plate guided growth hardware failure hemiepiphysiodesis |
| title | Complications and errors in guided growth surgery |
| title_full | Complications and errors in guided growth surgery |
| title_fullStr | Complications and errors in guided growth surgery |
| title_full_unstemmed | Complications and errors in guided growth surgery |
| title_short | Complications and errors in guided growth surgery |
| title_sort | complications and errors in guided growth surgery |
| topic | complication eight plate guided growth hardware failure hemiepiphysiodesis |
| url | http://www.jlimblengthrecon.org/article.asp?issn=2455-3719;year=2023;volume=9;issue=2;spage=70;epage=81;aulast=Burghardt |
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