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Temporary Hemiepiphysiodesis for Idiopathic Genua Valga in Adolescents: Percutaneous Transphyseal Screws (PETS) Versus Stapling

Brauwer, Veerle De MD; Moens, Pierre MD

Journal of Pediatric Orthopaedics: July/August 2008 - Volume 28 - Issue 5 - pp 549-554
doi: 10.1097/BPO.0b013e31817baab2
Lower Extremity: Original Article

Background: Genua valga are not merely a cosmetic problem but also predispose to gonarthrosis in adult life. In our retrospective study of 25 patients, we reviewed our present technique of medial hemiepiphysiodesis using percutaneous screws and compared it with our own results of stapling.

Methods: Clinical evaluation was performed by estimation of the intermalleolar distance, radiological assessment by measuring the hip-knee-ankle angle until skeletal maturity. Average chronological age at the time of surgery was 14.5 years for boys and 12.7 years for girls. Average bone age (main indicator for timing of surgery) was 14.3 years for boys and 12.8 years for girls.

Results: There is an average rebound phenomenon after removal of the screws of 2 degrees in one third of our patients. In another third of our patients' population, however, we observed a progression of correction of an average of 2 degrees. More than 90% of the patients were satisfied. None received revision surgery. There was only one person with an uncosmetic scar.

Conclusions: Percutaneous screws as treatment of idiopathic genua valga in children seem to be as safe and reliable as stapling but are a less invasive and a more cosmetic treatment.

Level of evidence: Our study is a level 3 study in which we compared, in a retrospective way, our results of percutaneous screws with stapling, both performed at our department.

From the Department of Pediatric Orthopaedic Surgery, UZ Pellenberg, Lubbeek (Pellenberg), Belgium.

None of the authors received financial support for this study.

Reprints: Veerle De Brauwer, MD, Department of Pediatric Orthopaedic Surgery, UZ Pellenberg Weligerveld, 1, B-3212 Lubbeek (Pellenberg), Belgium. E-mail:

© 2008 Lippincott Williams & Wilkins, Inc.