Knee & LegGuided growth using a tension-band plate in Blount’s diseaseMaré, Pieter Hermana,b; Thompson, David Mungoa,b; Marais, Leonard Charlesb Author Information aDepartment of Orthopaedic Surgery, Grey’s Hospital bDepartment of Orthopaedic Surgery, School of Clinical Medicine, University of KwaZulu-Natal, South Africa Received 23 June 2020 Accepted 10 January 2021 Correspondence to Pieter Herman Maré, MBChB, FC Orth (SA), Head Clinical Unit, Paediatric Orthopaedics, P.O. Box 351, Msunduzi 3231, Pietermaritzburg, South Africa, Tel: +27 33 897 3050; e-mail: [email protected] Journal of Pediatric Orthopaedics B 31(2):p 120-126, March 2022. | DOI: 10.1097/BPB.0000000000000854 Buy Metrics Abstract Our observational study’s objective was to determine how effective guided growth with tension-band plates was to correct the deformity in Blount’s disease. We reviewed the records of 14 children (18 limbs) with Blount’s disease who were treated with tension-band plates as the only surgical intervention at a single institution over eight years. Five children (seven limbs) had infantile Blount’s disease with Langenskiöld stage ≤2. Nine children (11 limbs) had late-onset Blount’s disease. The mean age at operation was 7.2 years (SD, 3.1, range, 2.9–11.8). The tension-band plate effectively corrected the varus deformity in 78% (14/18) of limbs. Correction to normal mechanical alignment was achieved in 67% (n = 12) of limbs at a mean of 18 months (SD, 7, range, 9–31). Failure to achieve correction of the mechanical axis was due to delayed implant removal and overcorrection in 11% (2/18), mechanical failure due to screw fixation failure in 11% (2/18) and in 6% (1/18) due to a misplaced epiphyseal screw. There was a greater magnitude of correction in the Infantile Blount’s disease group (mean, 26°, SD, 9°) when compared to the children with late-onset Blount’s disease (13°, SD, 4°) (P = 0.021). The mean correction rate was 1.8°/month in the Infantile Blount’s disease group and 0.7°/month in the late-onset Blount’s disease group, respectively (P = 0.014). Our findings support the use of tension-band plating in Blount’s disease. Further research is required to determine the ideal indications and to investigate the long-term outcome of guided growth in Blount’s disease. Level of evidence: Level 4. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.