Hemiepiphysiodesis with Tension Band Plates versus Percutaneous Epiphysiodesis Transphyseal Screws: A Comparative Study

Abstract

Objectives: There are currently two major types of implants used to treat varus/valgus deformities in children: tension band plates (TBPs) and percutaneous epiphysiodesis transphyseal screws (PETS). While reports about TBP abound, there is a paucity of reports on PETS. In this preliminary report, we compared the clinical results for hemiepiphysiodesis using TBP to PETS. Materials and Methods: The retrospective single European center study included 44 patients with varus/valgus deformities who underwent guided growth between 2010 and 2016. Follow-ups occurred from implantation through implant removal or skeletal maturity. Limb alignment was assessed through full-length standing radiographs. Results: In the group treated with TBP, the average age at implantation was 11.3 years (range, 3.6–15.8 years). Plates were inserted for an average of 14.6 months (range, 3.0–42.0 months). The mechanical axis deviation (MAD) changed an average of 2.5 mm/month (range, 0.1–8.0 mm/month). In the PETS group, the mean age at implantation was 13.1 years (range, 10.9–15.8 years). Screws were inserted for an average of 10.0 months (range, 2.0–25.0 months). The change of MAD was 2.9 mm/month (range, 0.2–10.3 mm/month). Conclusions: PETS had a comparable correction effect with TBP. Besides the different implant types, the correction effect and the treatment time are influenced by the growth rate, the extent of the deformity, and the underlying disease. TBP is less likely to lose purchase than PETS, especially in younger children. PETS have a sufficient grip in adolescents, are less expensive, and can be inserted through smaller surgical incisions which provide better cosmetic outcomes. The ideal age for switching from TBP to PETS has yet to be determined. Level of Evidence: III.