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DOI: 10.1055/s-0037-1618396
Temporäre Hemiepiphyseodese zur Beinachsenkorrektur im Kindes- und Jugendalter
Indikation, Methoden und Ergebnisse einer wachstumslenkenden OperationTemporary hemiepiphysiodesis for lower limb axis correction in childhood and adolescenceIndication, methods and results of a growth-guiding operative treatmentPublication History
Publication Date:
23 December 2017 (online)
Zusammenfassung
Häufig finden sich im Kindes- und Jugend -alter valgische oder varische Beinachsen jenseits der physiologischen Norm. Die Ursachen für diese Achsfehler sind vielfältig. Spontane Korrekturen nach dem zehnten Lebensjahr sind selten. Darum bietet sich bei noch offenen Epiphysenfugen eine wachstumslenkende operative Behandlung an, die temporäre Hemiepiphyseodese. Mit Klammern, speziellen Platten oder Schrauben lässt sich das Wachstum einer Epiphysenfuge einseitig blockieren, wodurch sich im weiteren Wachstum eine graduelle Korrektur einstellt. Nach erreichter Achsausgradung wird das eingebrachte Material wieder entfernt. Bei noch ausreichendem Restwachstum kann auf diese Weise zuverlässig der Achsfehler korrigiert werden. Entscheidend ist, den richtigen Zeitpunkt für den Eingriff zu wählen.
Summary
In children and adolescents varus or valgus deviations of lower-limbs are frequently found beyond physiologic values. Etiologies of these deformities are various. In cases without spontaneous correction, temporary hemiepiphyseodesis, a growth-guiding surgical treatment, can be used while physes are still open. An open physis can be blocked unilaterally using staples, special plates or screws, resulting in gradual correction of axis deviations during further growth. The material is removed, once correction is achieved. Provided there is enough growth remaining, axis deviations can be corrected reliably. Correct timing of the procedure is crucial.
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