الفهرس 
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Abstract
Angular deformities around the knee, a common problemencountered in pediatric orthopedics, may often be managedexpectantly and with benign neglect, requiring onlyparental reassurance.
Most physiological deformitiespeak between 1 and 3 years (varus) or between 3 and6 years (valgus) and resolve spontaneously.
Pathologicalangular deformities can be either idiopathic or due tocongenital syndromes such as skeletal dysplasia.
Valgus deformities in excess of 10o can causeanterior knee pain, circumduction gait, and occasionallypatellofemoral instability.
Varus deformities may resultin lateral thrust, ligamentous laxity, and a waddling gait.
Regardless of whether the etiology is idiopathic, dysplastic,or related to an endocrinopathy, the common goal of surgicaltreatment is to restore and maintain a neutralmechanical axis.
Several methods have been described to attain normalalignment.
But a different hardware construct was adopted,employing a nonlocking extraperiosteal plate and twoscrews (eight-Plate); this construct guides the physis growthwith few complications and high efficacy.
The only contraindication forguided growth is physeal closure due to damage or toskeletal maturity.
All patients were examined: supine, standing and gait, foot progression angle symmetry, stature and limb length.
The intercondylar distance (forgenu varum deformity) or intermalleolar distance (for genu valgum deformity) were measured preoperatively for all cases.
Radiological evaluation of the affected knee:X-rays (antero posterior, lateral) and standing long filmsmeasuringmechanical tibiofemoral,lateral distal femoral and proximal medial tibial angles of knee joint were taken.
Determining the diseased bone segment can be based on measuring the lateral distal femoral angle and the medial proximal tibial angle.
The patients were investigated for the etiology of angular deformities and medical treatment (if needed) was taken simultaneously with the surgical treatment.
No immobilization required after surgery, and early weight-bearing is encouraged along with a rapid return to normal activities, partial weight bearing is allowed from the second day.
Full range of motion of the knee was encouraged and quadriceps muscle strengthening exercises also were advised for all cases.
Periodic follow up evaluations were performed to assess the deformity correction approximately every 3 monthswhich included measuring of the intercondylar or intermalleolar distanceuntil reaching the neutralization of the mechanical axis.
When clinical correction of the deformity was deemed satisfactory, a standing long film was obtained to confirm the clinical impression.
Plate removal is undertaken as day surgery and is recommended upon obtaining a neutral axis or slight overcorrection.
Following plate removal, periodic follow-up (until bone maturity) is recommended for all patients to assess if rebound growth, limb length discrepancy, or premature physeal closure had occurred