DEFICIENCIES OF CURRENT METHODS FOR THE TIMING OF EPIPHYSIODESIS

A review of 71 epiphysiodeses with adequate orthoroentgenographic and skeletal-age data was carried out to compare the accuracy of predictin g outcome among the methods of Anderson and Green, Menelaus, and Mosel ey. Differing the methodology did not have a meaningful effect on thei r similar but limited accuracy. We advocate the use of the Menelaus me thod, which is simple and based on chronologic age, as it proved as ac curate as any other method. The routine use of serial Gruelich and Pyl e skeletal-age data could not be shown to increase the accuracy in pre dicting outcome over serial chronologic-age data, and thus its value i n limb-length inequality is limited. Regardless of the method used, un predictable results occur in a proportion of patients. The patient and parents should be advised of this when planning strategies for limb-l ength discrepancy.