Epiphyseal stapling for angular deformity at the knee

R C Zuege, T G Kempken, W P Blount
Journal of Bone and Joint Surgery. American Volume 1979, 61 (3): 320-9
Fifty six patients with angular deformities of eighty-two knees were treated with epiphyseal stapling between 1954 and 1973 and followed until maturity. There were sixty-four knock-knees and eighteen bowlegs. In twelve patients with concurrent leg-length discrepancies, long legs were stapled asymmetrically. The deformities were allowed to overcorrect before the staples were removed, but the rebound phenomenon occurred in twenty-two patients with thirty-five deformities. In older children the staples were taken out when the legs looked straight. Exaggerated physiological deformities may correct spontaneously. They should not be stapled before the skeletal age of eleven in girls and twelve in boys. Secondary deformities are corrected earlier. There were no significant complications. Ten revisions of staples were necessary because of extrusion or shifting. The results were satisfactory or improved in 87 per cent of the deformities. When it is indicated epiphyseal stapling is a safe and effective method of correcting angular deformity at the knee in growing children.

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