Does screw position matter for guided growth in cerebral palsy hips?

doi:10.1302/0301-620X.102B9.BJJ-2020-0340.R1

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/24655

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题名:	Does screw position matter for guided growth in cerebral palsy hips?
作者:	Hsu, PJ;Wu, KW;Lee, CC;Lin, SC;Kuo, KN;Wang, TM
日期:	2020
上传时间:	2022-08-09T08:05:52Z (UTC)
出版者:	BRITISH EDITORIAL SOC BONE & JOINT SURGERY
ISSN:	2049-4394
摘要:	Aims Guided growth has been used to treat coxa valga for cerebral palsy (CP) children. However, there has been no study on the optimal position of screw application. In this paper we have investigated the influence of screw position on the outcomes of guided growth. Methods We retrospectively analyzed 61 hips in 32 CP children who underwent proximal femoral hemi epiphysiodesis between July 2012 and September 2017. The hips were divided into two groups according to the transphyseal position of the screw in the corona, plane: across medial quarter (Group 1) or middle quarter (Group 2) of the medial half of the physis. We compared pre- and postoperative radiographs in head-shaft angle (HSA), Reimer's migration percentage (MP), acetabular index (Al), and femoral anteversion angle (FAVA), as well as incidences of the physis growing-off the screw within two years. Linear and Cox regression analysis were conducted to identify factors related to HSA correction and risk of the physis growing-off the screw. Results A total of 37 hips in Group 1 and 24 hips in Group 2 were compared. Group 1 showed a more substantial decrease in the HSA (p = 0.003) and the MP (p = 0.032). Both groups had significant and similar improvements in the Al (p = 0.809) and the FAVA (p = 0.304). Group 1 presented a higher incidence of the physis growing-off the screw (p = 0.038). Results of the regression analysis indicated that the eccentricity of screw position correlated with HSA correction and increases the risk of the physis growing-off the screw. Conclusion Guided growth is effective in improving coxa valga and excessive femoral anteversion in CP children. For younger children, despite compromised efficacy of varus correction, we recommend a more centered screw position, at least across the middle quarter of the medial physis, to avoid early revision.
URI:	http://dx.doi.org/10.1302/0301-620X.102B9.BJJ-2020-0340.R1 https://www.webofscience.com/wos/woscc/full-record/WOS:000564463400018 https://ir.csmu.edu.tw:8080/handle/310902500/24655
關聯:	BONE & JOINT JOURNAL ,2020 ,v102B ,issue 9 ,p1242-1247
显示于类别:	[中山醫學大學研究成果] 期刊論文

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