SURGICAL-MANAGEMENT OF ANKLE VALGUS IN CHILDREN - USE OF A TRANSPHYSEAL MEDIAL MALLEOLAR SCREW

Valgus deformity of the ankle in children is associated with a wide va riety of clinical conditions. A retrospective review was performed of 17 children (29 involved extremities) with ankle valgus deformity who had been managed by use of a percutaneously placed, transphyseal media l malleolar screw. Median age at the time of surgery was 11 years, 2 m onths. Median postoperative follow-up was 2 years, 2 months. Tibiotala r axis and ankle mechanical axis were the best radiographic indicators of ankle valgus deformity. Fibular station and epiphyseal wedging wer e poor predictors of ankle alignment. Significant improvement in the t ibiotalar axis (median, 12 degrees) was noted at follow-up, and the me dian rate of correction was 0.59 degrees/month. Resumption of physeal growth and recurrence of deformity (rate of 0.60 degrees/month) was se en when the screws were removed before skeletal maturity. The transphy seal medial malleolar screw is a minimally invasive, minimally morbid, technically simple method of reversible partial epiphysiodesis at the ankle and is an effective technique for the correction of ankle valgu s deformity associated with a wide variety of clinical conditions in c hildren.