Epiphysiodesis is a surgical procedure performed to halt the growth of the epiphyseal plate, or growth plate, in children and adolescents. It is often used to address discrepancies in limb length or certain angular deformities. By stopping growth at the growth plate, physicians can help achieve more equal limb lengths or correct improper bone alignment as the child continues to grow.
This procedure is typically indicated for children with significant limb length discrepancies. These discrepancies can arise due to congenital factors, trauma, infection, or diseases such as
dysplasia. In some cases, it may also be used to address angular deformities that could lead to future complications if left untreated. The timing of the procedure is crucial, as it must be done before the growth plates close naturally.
The procedure can be executed using different techniques, including
percutaneous, open surgical methods, or using screws. The choice of technique depends on the specific clinical needs of the patient. During surgery, the growth plate is either removed or damaged to stop further growth. The procedure is typically done under
general anesthesia and may require a short hospital stay for recovery.
As with any surgical procedure, epiphysiodesis carries risks such as infection, bleeding, and
anesthesia reactions. Long-term complications may include overcorrection, undercorrection, or unintended angular deformities. It's also possible for there to be discrepancies in limb length if the procedure is not timed correctly with the child's growth.
Determining the optimal timing for epiphysiodesis involves careful assessment of the child's current growth rate, predicted future growth, and the specific limb length discrepancy. Physicians often use
growth charts and imaging studies such as X-rays to make these assessments. The goal is to perform the procedure when it will most effectively equalize limb lengths by the time growth stops.
Recovery from epiphysiodesis generally involves a short period of rest followed by gradual return to normal activities. Physical therapy may be recommended to maintain strength and flexibility in the affected limb. Most children can resume normal activities within a few weeks, although contact sports might be restricted for a longer period.
Alternatives to epiphysiodesis include
limb lengthening procedures, which can be more invasive and require longer recovery times. In some cases, non-surgical options such as shoe lifts can be considered, especially if the length discrepancy is minimal. The choice of treatment depends on the severity of the discrepancy, the age of the child, and the family's preferences.
The prognosis following epiphysiodesis is generally positive, especially when the procedure is carefully timed and executed. Most children achieve satisfactory limb length equality or correction of angular deformities, allowing them to engage in normal activities without limitations. Regular follow-up is essential to monitor the outcome and ensure the desired result is achieved as growth completes.
