J Am Acad Orthop Surg, Vol 18, No 9, September 2010 Neil Saran, MD and Karl E. Rathjen, MD
Guided growth is useful in correcting pediatric angular deformities. Although growth manipulation has been applied to various deformities, it is most commonly used to correct coronal plane deformity about the knee. Temporary hemiepiphysiodesis is performed using staples, percutaneous transphyseal screws, or a tension band plate. Permanent hemiepiphysiodesis can be done using either an open Phemister or a percutaneous approach. These techniques function by tethering one side of a growing physis, thereby allowing differential growth. Applied correctly, this can also result in angular deformity correction. Undercorrection and overcorrection are common problems with guided growth. However, careful preoperative planning and appropriate follow-up can minimize complications and allow for excellent deformity correction with minimal morbidity.