Clinical Outcomes and Correction Rates of Valgus and Varus Deformities Treated with Temporary Hemiepiphysiodesis Using Tension Plates: A Retrospective Cohort Study

TL;DR

This study shows that using tension-band plates for guided growth is safe and effective for correcting knee deformities in children, especially for idiopathic valgus cases.

Contribution

The study provides empirical evidence on correction rates and outcomes of tension-band plate hemiepiphysiodesis for knee deformities in skeletally immature patients.

Findings

Idiopathic valgus deformities showed significant correction with annual rates of 4.75°/year for mLDFA and −1.74°/year for mMPTA.

Patients with pathological physes had inconsistent outcomes and often required additional procedures.

No major complications were observed in the study cohort.

Abstract

Background and Objectives: Coronal plane deformities of the knee, particularly genu valgum and varum, represent common indications for guided growth in pediatric orthopedics. This study evaluates the clinical and radiographic outcomes of temporary hemiepiphysiodesis using tension-band plates in skeletally immature patients and identifies factors associated with successful correction. Materials and Methods: A retrospective review was conducted on patients treated with tension-band plate hemiepiphysiodesis for knee valgus or varus deformities between 2012 and 2023. Inclusion required open physes, pre- and postoperative full-length radiographs, and follow-up until implant removal or skeletal maturity. Mechanical axis parameters (mLDFA, mMPTA) were compared pre- and postoperatively, and correction rates were calculated. Idiopathic cases were analyzed separately from those with neurological or osteological disorders. Results: Sixty-six limbs were included (51 valgus, 15 varus). In the idiopathic subgroup, significant correction was achieved, with mLDFA improving by +5.19° and mMPTA by −1.88°, corresponding to annual correction rates of 4.75°/year and −1.74°/year, respectively (p < 0.001). Regression analysis showed no significant predictive value of age or treatment duration for total correction. Patients with pathological physes demonstrated inconsistent outcomes, often requiring additional procedures. No major complications occurred. Conclusions: Temporary hemiepiphysiodesis using tension-band plates is a safe, minimally invasive, and highly effective method for correcting idiopathic valgus deformities in growing children, with correction rates comparable to the existing literature. Outcomes in patients with neurological or osteological comorbidities remain less predictable, underscoring the need for individualized planning and close follow-up.

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