2026-04-13T14:24:58Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/116182025-10-24T10:22:18Zcom_2072_378070com_2072_378040col_2072_378092

How to avoid genu recurvatum in leg-length discrepancy treated with tension-band plates. A volumetric magnetic resonance analysis Jurado Ruiz, Maria Rovira Martí, Pilar Riera, Luis Fontecha, Cesar G Articulació femorotibial - Malformacions Cartílags de creixement Imatgeria per ressonància magnètica Ossos - Diferenciació DISEASES::Musculoskeletal Diseases::Joint Diseases::Joint Deformities, Acquired ANATOMY::Musculoskeletal System::Skeleton::Joints::Knee Joint DISEASES::Musculoskeletal Diseases::Bone Diseases::Bone Diseases, Developmental::Leg Length Inequality ANATOMY::Musculoskeletal System::Skeleton::Bone and Bones::Epiphyses::Growth Plate ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Tomography::Magnetic Resonance Imaging ENFERMEDADES::enfermedades musculoesqueléticas::artropatías::deformidades adquiridas de las articulaciones ANATOMÍA::sistema musculoesquelético::esqueleto::articulaciones::articulación de la rodilla ENFERMEDADES::enfermedades musculoesqueléticas::enfermedades óseas::enfermedades óseas del desarrollo::diferencia de longitud de las piernas ANATOMÍA::sistema musculoesquelético::esqueleto::huesos::epífisis::placa de crecimiento TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::tomografía::imagen por resonancia magnética Temporary epiphysiodesis; Growth plate; Genu recurvatum Epifisiodesis temporal; Placa de crecimiento; Genu recurvatum Epifisiodesi temporal; Placa de creixement; Genu recurvatum Aims and objectives Genu recurvatum deformity after treatment of leg-length discrepancy (LLD) with tension-band plating is a recognized, but poorly described phenomenon in medical literature. The aim of this study was to evaluate clinical and radiological features of patients treated with tension-band plating for LLD assessing the development of a recurvatum deformity and its relationship to plate and screw disposition in a transversal plane, thus attempting to establish optimal plate positioning. Materials and methods Retrospective study of children with LLD treated with tension-band plating. Primary endpoints were clinical and radiological knee recurvatum and anterior and posterior physeal areas measured drawing a line spanning from the lateral to the medial tension-band plates in the transverse plane using volumetric magnetic resonance imaging (vMRI). These findings were compared between patients with and without knee recurvatum. Results Twelve children (mean age 11.7 years) were included. Average follow-up was 2.6 years (1.5–5.0). Tension-band plating led to a significant reduction in LLD (mean, 15 mm). Six patients (50 %) developed clinical genu recurvatum (mean, 22°). According to vMRI, patients with genu recurvatum had a larger posterior to anterior physeal area ratio in both distal femur (1.6 versus 0.9, p < 0.05) and proximal tibial physes (2.2 versus 1.0, p < 0.05). Conclusion The optimal position of the tension-band plates in distal femoral and proximal tibial physes should be in a point where a posterior to anterior physeal areas ratio is around 1.0, so as to achieve an even distribution of the physeal areas in the multidimensional physeal transverse plane. This point anatomically corresponds in the sagittal X-ray view to an imaginary line located just anterior to the posterior diaphyseal cortical bone on a true lateral radiograph for both femur and tibia. 2025-10-24T10:22:18Z 2025-10-24T10:22:18Z 2025-10-24T10:22:18Z 2024-06-20T07:20:37Z 2024-06-20T07:20:37Z 2024-11 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/11618 Journal of Orthopaedics;57 https://doi.org/10.1016/j.jor.2024.06.004 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Elsevier Scientia