الفهرس 
Aim of The WorkOnly 14 pages are availabe for public view
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Abstract
physiologic bowing of the lower extremities. physiologic genu varum is common, The hallmark of this condition is symmetrical and painless bowing, usually associated with in-toeing and often with a propensity for tripping. This problem will resolve spontaneously without treatment, as a result of normal growth.
There are a variety of options for intervention, ranging from attempted bracing to osteotomy However, osteotomies are relatively invasive and fraught with potential complications (e.g., failure of fixation, physeal damage, infection, joint stiffness, compartment syndrome, neurovascular injury, over- or under correction, and recurrent deformity).
Guided growth (temporary hemi-epiphysiodesis) is a minimally invasive and modular method of correcting genu varum in the pediatric patient. The key advantage of this intervention is its temporary and reversible nature. However, problems experienced with staples, including migration or breakage and the necessity of premature revision surgery, detracted from the popularity of this approach and led to the development of alternative methods, including the percutaneous transphyseal screw and, subsequently, the eight-Plate (Orthofix, Verona, Italy).
Alternatives to the eight-Plate that appear to have comparable efficacy, but greater cost-effectiveness have been studied. Follow-up visits were scheduled for every 3 months. Repeat radiographs are obtained as indicated. Plate removal is carried out when the mechanical axis is neutral or minimally overcorrected into lateral zone.
This study aimed to evaluate the clinical and radiological outcome of treatment of pediatric genu varum with hemi-epiphysiodesis with 8-shaped plate.
The case series clinical study included thirty children who had suffered from genu varum that were studied in antegrade and retrograde manners between the ages of 3 and 15. The patients underwent clinical examination, radiological evaluation, and laboratory investigations before the operation. The surgical procedure was done under general anesthesia, and the patients were evaluated for various criteria, such as operation time, intraoperative and postoperative complications, radiological follow-up, and hospital stay. The final follow-up was six months after the surgery.
• Summary of our results:
• The current study was carried on 30 child suffering from genu varum and underwent correction with 8 plate insertion. Their mean age was 6.6 years. Gender distributed as 43% females and 57% males. Their mean BMI was 21.27 kg/m2.
• According to side of correction, 77% had bilateral correction, 10% had correction in the left side while 13% had correction in the right side. Correction carried on both femur and tibia in 50% of subjects, 10% had correction in femur and 40% had correction in tibia.
• Mean days of hospitalization was 0.8 days ranged from zero to 2 days and mean deformity correction time was 10.6 months.
• According to time of removal of plates, mean time of removal was 12.57 months. Outcome in patients distributed as 7% with superficial infections, 10% had limited ROM, 3% had broken screws and 80% had no complications.
• The parameters under study were compared with respect to the occurrence of complications. Significant differences were detected in the location of the deformity, the site of 8 plate implementation, and the presence of rebound phenomenon between the complicated and non-complicated groups. Bilateral deformity was more frequent in the non-complicated group (88%) compared to the complicated group (33.3%), while right and left deformities were more common in the complicated group than the non-complicated group. Rebound phenomenon was observed in 17% of complicated cases, whereas non-complicated cases did not exhibit rebound phenomenon.
• There was a significant p-value (<0.001*) in the Inter condylar distance (ICD) when compared at 0, 3, 6, 9, 12, and 15 months after correction. The mean measurement at the beginning of the study was 10.3 cm, and at the end of the study, it was 0.78 cm.
• The mechanical axis deviation on the right side in corrected genu varum showed a statistically significant difference between the repeated measurements done by ANOVA test.
• Left side corrected genu varum showed statistically significant difference between repeated measurements done by ANOVA test.
• Lateral distal femur angle repeated measurements showed a significant p value when assessed at 0,3,6,9,12 and 15 months in both right and left sides.
• Medial proximal tibial angle repeated measurements showed a significant p value when assessed at 0,3,6,9,12 and 15 months in both right and left sides.
• Logistic regression analysis was conducted for the prediction of rebound phenomenon using age, BMI, Correction side, plates time of removal, hospital stay and correction time. All parameters used in regression analysis were not shown as a significant risk factor for rebound phenomenon.
• Logistic regression analysis was conducted to predict complications using age, BMI, correction side, plate removal time, hospital stay, and correction time as predictor variables. In univariate analysis, the left deformity side and time of plate removal were found to be associated with the risk of complications.
Conclusions