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The biomechanics of guided growth: does screw size, plate size, or screw configuration matter?

Schoenleber, Scott J.a; Iobst, Christopher A.b; Baitner, Avib; Standard, Shawn C.c

Journal of Pediatric Orthopaedics B:
doi: 10.1097/BPB.0000000000000026

Guided growth with the eight-plate is a commonly used technique to correct angular limb deformities in children. However, the optimal combination of plate size, screw size, and screw configuration has not been determined. Using osteotomized femoral sawbones and a rail frame, we developed a growth model to examine the effect of these variables at 6-month, 12-month, and 18-month growth increments. The mean annual coronal plane change was 11.3°. Screw size and plate size were not associated with the rate of angular correction. Screw configuration was important, with parallel screws resulting in optimal correction at all time points compared with divergent screws (P<0.05).

Author Information

aDepartment of Orthopaedics, Jackson Memorial Hospital, University of Miami

bDepartment of Orthopaedic Surgery, Miami Children’s Hospital, Miami, Florida

cRubin Institute for Advanced Orthopaedics, Baltimore, Maryland, USA

Correspondence to Christopher A. Iobst, MD, Department of Orthopaedic Surgery, Miami Children’s Hospital, 3100 SW 62nd Avenue, Miami, FL 33155, USA Tel: +1 305 662 8366; fax: +1 305 663 9194; e-mail:

© 2014 by Lippincott Williams & Wilkins, Inc.