Abstract

MISCIONE, Fernando; GOYENECHE, Rodolfo; PRIMOMO, Claudio  and  MISCIONE, Horacio. Growth modulation in renal osteodystrophy. Rev. Asoc. Argent. Ortop. Traumatol. [online]. 2012, vol.77, n.3, pp.171-177. ISSN 1852-7434.

Background: Renal osteodystrophy causes progressive mechanical axis deviation, most often genu valgum, of the lower limbs. Guided growth is a useful procedure for the correction of angular deformities in children. Temporary partial closure of the physis (hemiepiphysiodesis) is a good therapeutic option. The aim of this study was to show the outcome and complications of this surgical procedure in pathological physes. Methods: We present 11 patients (20 knees) diagnosed with chronic renal insufficiency and genu valgum who underwent temporary hemiepiphysiodesis at our Department. Eight-plates were placed in four patients and stapling was performed in the remaining seven. Pre and post-operative mechanical axis was evaluated on radiographs and the complications associated with each implant were assessed. Results: Complete correction was obtained in four patients, one of whom suffered from recurrence of the deformity, and the remaining patients improved without achieving full normalization of the mechanical axis. Conclusions: The correction achieved was clearly related to the recovery of kidney function. Patients who underwent kidney transplantation achieved adequate catch-up bone growth. No differences were found in outcome or complications between the two implants used.

Keywords : Guided growth; Growth modulation; Hemiepiphysiodesis; Pathological physes; Renal osteodystrophy.

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