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Concomitant Tibia Shaft And Triplane Fracture in Adolescents: A Case Series with Comprehensive Review of Literature

Volume 8 | Issue 2 | May-August 2022 | Page: 11-15 | K Venkatadass, V Durga Prasad, Deepak Jain, S Rajasekaran DOI- https://doi.org/10.13107/ijpo.2022.v08i02.138 Authors: K Venkatadass MS Orth [1], V Durga Prasad D Orth [1], Deepak Jain MS Orth [1], S Rajasekaran MS Orth [1] [1] Department of Orthopaedics & Spine Surgery, Ganga Hospital, Coimbatore, […]

Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Volume 8 | Issue 2 | May-August 2022 | Page: 06-10 | Sandeep Patwardhan, Arkesh Madegowda, Sujith Omkaram, Pavan Patil, Ashok Shyam, Parag Sancheti DOI- https://doi.org/10.13107/ijpo.2022.v08i02.137 Authors: Sandeep Patwardhan MS Ortho [1], Arkesh Madegowda MS Ortho [1], Sujith Omkaram MS Ortho [1], Pavan Patil MS Ortho [1], Ashok Shyam MS Ortho [1], Parag Sancheti MS Ortho […]

Concomitant Tibia Shaft And Triplane Fracture in Adolescents: A Case Series with Comprehensive Review of Literature

Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

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Concomitant Tibia Shaft And Triplane Fracture in Adolescents: A Case Series with Comprehensive Review of Literature

Volume 8 | Issue 2 | May-August 2022 | Page: 11-15 | K Venkatadass, V Durga Prasad, Deepak Jain, S Rajasekaran

DOI- https://doi.org/10.13107/ijpo.2022.v08i02.138

Authors: K Venkatadass MS Orth [1], V Durga Prasad D Orth [1], Deepak Jain MS Orth [1], S Rajasekaran MS Orth [1]

[1] Department of Orthopaedics & Spine Surgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.

Address of Correspondence
Dr. K Venkatadass,
Consultant & Head of Paediatric Orthopaedics, Department of Orthopaedics & Spine Surgery, Ganga Hospital, Coimbatore, Tamil Nadu, India.
E-mail: venkatpedortho@gmail.com

Abstract

Concomitant tibia shaft and ipsilateral triplane fracture in the paediatric population is a known but uncommon presentation. After the first report in 2001, approximately 27 cases have been reported to date. We aimed to do a comprehensive literature review and to present our experience with these rare fractures. We report three such cases of distal-third spiral tibial fractures with three-part triplane fracture. The average age was 15.3 years. The average Body mass index was 31.3 kg/m2. Two patients underwent rigid intramedullary locking nail for shaft fractures, and one patient underwent Ender’s nailing. All triplane fractures were fixed with percutaneous screws. There were no intraoperative or postoperative complications. The average union time was 10.6 weeks. We highlight the patient and injury characteristics in these fractures. A high index of suspicion of an associated ankle fracture is needed in obese adolescents presenting with distal-third tibia fractures. Tibia fractures demand rigid internal fixation whenever possible due to associated obesity.
Keywords: Concomitant, Ipsilateral, Triplane, Tibia, Shaft, Ankle Fracture, Obesity

References

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13. Lurie, B., Van Rysselberghe, N., Pennock, A. T., & Upasani, V. V. (2020). Functional outcomes of tillaux and triplane fractures with 2 to 5 millimetres of intra-articular gap. Journal of Bone and Joint Surgery, 102(8), 679–686.
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How to Cite this Article: K Venkatadass, V Durga Prasad, Jain D, S Rajasekaran | Concomitant Tibia Shaft And Triplane Fracture in Adolescents: A Case Series With Comprehensive Review Of Literature | International Journal of Paediatric Orthopaedics | May-August 2022; 8(2): 11-15.
https://doi.org/10.13107/ijpo.2022.v08i02.138

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Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Volume 8 | Issue 2 | May-August 2022 | Page: 06-10 | Sandeep Patwardhan, Arkesh Madegowda, Sujith Omkaram, Pavan Patil, Ashok Shyam, Parag Sancheti

DOI- https://doi.org/10.13107/ijpo.2022.v08i02.137

Authors: Sandeep Patwardhan MS Ortho [1], Arkesh Madegowda MS Ortho [1], Sujith Omkaram MS Ortho [1], Pavan Patil MS Ortho [1], Ashok Shyam MS Ortho [1], Parag Sancheti MS Ortho [1]

[1] Department of Paediatric Orthopaedics Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.

Address of Correspondence
Dr. Arkesh Madegowda,
Clinical Fellow, Department of Paediatric Orthopaedics Sancheti Institute for Orthopaedics and Rehabilitation, Pune, Maharashtra, India.
E-mail: dr.arkesh@gmail.com

Abstract

Objectives: To report the incidence of overcorrection as complication following eight-plate application for genu varum/valgum deformities and its management.
Methods: This was a retrospective review of children who underwent growth modulation for genu varum/valgum between 2012-2019. Data of patients who had presented with overcorrection of their primary deformity, the reasons for such complication and its management were collected and analysed.
Results: 110 children had undergone growth modulation during the study period. 75 children (68%) had achieved deformity correction in mean time of 14.4 months and had their implant removed on time when intercondylar (ICD)/intermalleolar (IMD) distance was ≤ 5 centimeters (cms) and/or Hip Knee Ankle (HKA) angle was < ±6⁰. 29 children (26%) were lost to follow up. 6 children (5.4%) had presented with overcorrection of moderate to severe grade with mean ICD/IMD of 13.3 cms (range 11-18) and mean HKA angle of 14.3⁰ (range 11-21⁰). Mean age of initial surgery was 6.1 years (range 5-8). Mean time gap of presentation with overcorrection was 33.6 months (range 24-45). Lack of awareness, long distance of hospital, medical expenses were some of the notable reasons for irregular follow-up. All 6 had an open physes with growth remaining when they presented with overcorrection. These children managed with repeat growth modulation. Final correction was achieved at mean time of 15.3 months and underwent implant removal. At the latest follow up of 4.4 years, limb alignment within physiologic limits was maintained.
Conclusion: Children undergoing growth modulation should be carefully monitored with regular follow-up to avoid complication of overcorrection. Overcorrection beyond physiologic limits can be managed with repeat growth modulation in younger children with open physes.
Keywords: Growth modulation, Genu valgum, Genu varum, Irregular follow up, Complication, Overcorrection.

References

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7. Zajonz D, Schumann E, Wojan M, Kübler FB, Josten C, Bühligen U, Heyde CE. Treatment of genu valgum in children by means of temporary hemiepiphysiodesis using eight-plates: short-term findings. BMC Musculoskelet Disord. 2017 Nov 15;18(1):456.
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14. Masquijo JJ, Artigas C, de Pablos J. Growth modulation with tension-band plates for the correction of paediatric lower limb angular deformity: current concepts and indications for a rational use. EFORT Open Rev. 2021 Aug 10;6(8):658-668.
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How to Cite this Article: Patwardhan S, Madegowda A, Omkaram S, Patil P, Shyam A, Sancheti P | Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management | International Journal of Paediatric Orthopaedics | May-August 2022; 8(2): 06-10.
https://doi.org/10.13107/ijpo.2022.v08i02.137

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Concomitant Tibia Shaft And Triplane Fracture in Adolescents: A Case Series with Comprehensive Review of Literature

Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Concomitant Tibia Shaft And Triplane Fracture in Adolescents: A Case Series with Comprehensive Review of Literature

Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Full Sized Blog Element (Big Preview Pic)

Concomitant Tibia Shaft And Triplane Fracture in Adolescents: A Case Series with Comprehensive Review of Literature

Authors: K Venkatadass MS Orth [1], V Durga Prasad D Orth [1], Deepak Jain MS Orth [1], S Rajasekaran MS Orth [1]

Abstract

(Article Text HTML) (Full Text PDF)

Overcorrection as Complication of Growth Modulation with Eight-Plate for Coronal Plane Deformities of Knee and its Management

Authors: Sandeep Patwardhan MS Ortho [1], Arkesh Madegowda MS Ortho [1], Sujith Omkaram MS Ortho [1], Pavan Patil MS Ortho [1], Ashok Shyam MS Ortho [1], Parag Sancheti MS Ortho [1]

Abstract

(Article Text HTML) (Full Text PDF)

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