Distal femoral hemiepiphysiodesis with screws and suture versus 8-plate for the treatment of genu valgum in children.

INTRODUCTION: There are different techniques for gradual correction of angular deformities in lower limbs. The use of screws and non-absorbable filament have been described as an effective alternative for transitory hemiepiphysiodesis in pediatric population.

HYPOTHESIS: In pediatric population with genu valgum there are no differences in outcome between hemiepiphysiodesis, using screws and non-absorbable filament (SNAF) versus 8-plate.

METHODS: Retrospective evaluation, 44 knees in 22 patients younger than 15 years, with idiopathic genu valgum, were operated on. One group (20 knees) was operated on with 8-plate technique and another group (24 knees) was operated on with SNAF technique. Initial and final intermalleolar distance (IMD) and mechanical lateral distal femoral angle (mLDFA) were compared, registering complications for each group. Mann-Whitney test was used for statistics, with significance value <0.05.

RESULTS: All patients achieved the expected mechanical axis correction. IMD and mLDFA significatively improved. There were no significant differences in magnitude and speed of correction when comparing the two techniques. Only one SNAF patient had a minor perioperative complication.

DISCUSSION: This report compares postoperative results between SNAF and 8-plate technique for correction of angular deformities in lower limbs. In this series of patients, significant clinical and radiological changes were observed between the initial and final values using both techniques, with no significant differences between them. Our group proposes the SNAF technique as an efficient, simple and cost-effective alternative to the traditional 8-plate technique, for the treatment of idiopathic genu valgum in children.

LEVEL OF EVIDENCE: III, retrospective comparative study.