HEMIEPIPHYSEAL STAPLING FOR KNEE DEFORMITIES IN CHILDREN YOUNGER THAN10 YEARS - A PRELIMINARY-REPORT

Epiphyseal stapling, which is the only reversible method of growth alt eration, has traditionally been reserved for teenagers. We are reporti ng the application of hemiepiphyseal stapling in a series of 25 childr en younger than 10 years. With a variety of underlying diagnoses, thre e children had genu varum and 22 had genu valgum. The technique involv ed fluoroscopic localization of all growth plates and careful preserva tion of the periosteum while inserting (and subsequently removing) one or two staples per physis. The mean age at stapling was 6 years + 4 m onths. Follow-up averaged 3 years + 3 months. The anatomic (tibiofemor al) angle and mechanical axis improved in all patients, One staple bro ke on removal; there were no other hardware failures. We conclude that hemiepiphyseal stapling is a safe and effective treatment for childre n younger than 10 years who have angular deformities of the knee. No g rowth-plate arrests have occurred. In the event of recurrent deformity , stapling may be repeated.