Persistent Torsional Deformity in Paediatric Genu Varum after Coronal Plane Deformity Correction by 8-Plate Hemi-Epiphysiodesis
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Abstract
Introduction: Angular deformities around the knee, i.e., genu varum and genu valgum, are common in children and can arise from various underlying conditions. Surgical treatment options include temporary hemi-epiphysiodesis (guided growth), which is less invasive and carries fewer risks compared to traditional osteotomies. While effective for coronal deformities, the impact of this technique on persistent torsional deformities remains underexplored.
Objectives: This study aims to assess the persistent torsional deformity following complete correction of varus coronal deformity in pediatric patients treated with 8-plate hemi-epiphysiodesis.
Methods: A retrospective case series study was conducted in a tertiary center from March 2023 to January 2025. The study included skeletally immature patients aged 2.5 to 12 years with genu varum deformity who underwent 8-plate hemi-epiphysiodesis for varus deformity correction. Clinical and radiological assessments-including foot progression angle, thigh-foot angle and heel bisector line- were used to evaluate rotational deformities after varus correction.
Results: A total of 26 limbs of 14 patients with mean age 4.54 years were analyzed. The mean duration of epiphysiodesis was 10.46 months. Despite successful correction of coronal deformities, 61.5% of patients exhibited persistent intoeing. The persistent torsion was of tibial source which was manifested in the foot progression angle and the thigh-foot angle.
Conclusion: While 8-plate is effective for coronal deformity correction in pediatric genu varum, a significant proportion of patients retain persistent torsional deformities.
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