Temporary epiphysiodesis with Blount stapling for treatment of idiopathic genua valga in children


Published online: Oct 27 2003

Ilse DEGREEF, Pierre MOENS, Guy FABRY

From the University Hospital of Leuven (U.Z. Pellenberg), Belgium.

Abstract

Not all idiopathic genua valga in children show an innocuous evolution. If the deformity persists or increases, it can cause a long-term cosmetic or functional problem. The problem can easily be corrected, with only limited risks for complications, with temporary medial hemi-epiphysiodesis of the growth plates around the knees. This retrospective study considers the pre- and postoperative evolution of 44 patients who underwent temporary stapling of the medial femoral and tibial physes following Blount’s technique. Ninety percent were satisfied and showed good correction of the knee alignment. Four patients were not satisfied with the result, owing to recurrence of the valgus deformity ; two of them had a good result after revision surgery. The condition was assessed by measuring clinically the intermalleolar distance and the radiological hip-knee-ankle angle. Average age at the time of surgery was 12 years six months for girls and 13 years eight months for boys. Pre-operative evaluation of skeletal age on radiographs of the hand is advised. There is a rebound phenomenon after hardware removal, with an average recurrence of the valgus deformity of 4°. Blount stapling appears as a reliable method for treatment of idiopathic genua valga in children, with satisfactory results and few complications.