Transphyseal screws correct coronal deformities faster than growth modulation plates in distal femoral guided growth

Key findings of the study:

• The average age (and standard deviation) at the time of the procedure was 12.9 ± 1.1 years.

• Both the MAD and LDFA rate of correction significantly differed between the screw and plate cohorts.

• The MAD rate of correction was observed to be 0.42 ± 0.37 mm/week (1.69 mm/month) in the plate cohort and 0.66 ± 0.51 mm/week (2.64 mm/month) in the screw cohort.

• The LDFA rate of correction was observed to be 0.120 ± 0.130/week (0.500/month) in the plate cohort and 0.190 ± 0.190/week (0.770/month) in the screw cohort.

The authors concluded that – “the current study is the first, to our knowledge, to retrospectively compare age- and sex-matched cohorts of coronal knee growth modulation utilizing transphyseal screws and growth modulation plates. This study generated proposed simple clinical references of the estimation of the rate of correction of the LDFA and MAD for both hemiepiphysiodesis methods. The results also suggest that transphyseal screws may affect optimal correction measured by MAD and the LDFA more quickly than growth modulation plates for distal femoral guided growth in coronal knee deformities during the initial months of treatment.”

Level of Evidence: Therapeutic Level III. 

Further reading:

Faster Rate of Correction with Distal Femoral Transphyseal Screws Versus Plates in Hemiepiphysiodesis for Coronal-Plane Knee Deformity

Age- and Sex-Matched Cohorts of Skeletally Immature Patients

James McGinley, Hannah Worrall et al

J Bone Joint Surg Am. 2023;105:1252-60

http://dx.doi.org/10.2106/JBJS.22.01122