Nueva publicación

¡Nos complace anunciar nuestra nueva publicación sobre el tratamiento guiado para discrepancias en la longitud de las extremidades!

Cómo evitar el genu recurvatum en la discrepancia de longitud tratada con placas de crecimiento guiado : Un análisis volumétrico mediante resonancia magnética

Autores: Maria Jurado Ruiz, Pilar Rovira, Luis Riera, César Galo García Fontecha

Aims and objectives: Genu recurvatum deformity after treatment of leg-length discrepancy (LLD) with tension- band plating is a recognized, but poorly described phenomenon in medical literature. The aim of this study was to evaluate clinical and radiological features of patients treated with tension-band plating for LLD assessing the development of a recurvatum deformity and its relationship to plate and screw disposition in a transversal plane, thus attempting to establish optimal plate positioning.

Materials and methods: Retrospective study of children with LLD treated with tension-band plating. Primary endpoints were clinical and radiological knee recurvatum and anterior and posterior physeal areas measured drawing a line spanning from the lateral to the medial tension-band plates in the transverse plane using volu- metric magnetic resonance imaging (vMRI). These findings were compared between patients with and without knee recurvatum.

Results: Twelve children (mean age 11.7 years) were included. Average follow-up was 2.6 years (1.5–5.0). Tension-band plating led to a significant reduction in LLD (mean, 15 mm). Six patients (50 %) developed clinical genu recurvatum (mean, 22◦). According to vMRI, patients with genu recurvatum had a larger posterior to anterior physeal area ratio in both distal femur (1.6 versus 0.9, p < 0.05) and proximal tibial physes (2.2 versus 1.0, p < 0.05).

Conclusion: The optimal position of the tension-band plates in distal femoral and proximal tibial physes should be in a point where a posterior to anterior physeal areas ratio is around 1.0, so as to achieve an even distribution of the physeal areas in the multidimensional physeal transverse plane. This point anatomically corresponds in the sagittal X-ray view to an imaginary line located just anterior to the posterior diaphyseal cortical bone on a true lateral radiograph for both femur and tibia.

Estamos emocionados de compartir estos importantes hallazgos que pueden mejorar significativamente los resultados clínicos en el tratamiento de discrepancias en la longitud de las extremidades.