Background: Angular deformities in children can be physiological or pathological, with the latter requiring surgical correction to prevent functional impairments. Guided growth through hemiepiphysiodesis is a minimally invasive alternative to osteotomies, enabling gradual correction by modulating growth in skeletally immature patients, thus reducing complications.
Objectives: To assess the efficacy of epiphysiodesis using 8 plates in management of deformities in children near skeletal maturity.
Patients and methods: This prospective patient series at Qena University Hospital, Egypt, involved 20 near skeletal maturity children with coronal knee deformities. Guided growth surgery was performed using 3.5–4.5 mm cannulated screws under fluoroscopic guidance. Postoperative care included antibiotics, partial weight-bearing mobilization, and follow-ups at 6, 9, and 12 months.
Results: The mean age was 11.5 ± 1.69 years. 35% were male. 80% had genu valgum and 20% genu varum. Bilateral involvement occurred in 75%. The femoral component was affected in 45%, tibial in 15%, and both in 40%. Preoperative mechanical angles showed a mean mLDFA of 84.2° (right) and 83.25° (left), MPTA of 88.26° (right) and 88.87° (left), and mTFA of 8.13° (right) and 6.84° (left). Postoperative improvement included mLDFA (right: 86.95°, left: 87.08°), MPTA (right: 88.53°, left: 88.27°), and mTFA (right: 1.65°, left: 1.86°). Full correction was achieved in 90% by 18 months, with significant reductions in mTFA (P = 0.0448). Complications included reoperation (5%), persistent pain (5%), and overcorrection (15%).
Conclusion: 8-plate hemiepiphysiodesis effectively corrects knee deformities in children near skeletal maturity with minimal complications.