Physeal bar resection in growth arrest in post-traumatic genu valgum

Abstract

Trauma in young patients often lead to physis injury and ground arrest which can eventually result into deformity. It may result in both limb length discrepency and angular deformity. The extent of growth arrest depends on type of injury and treatment received. Here in this case report, post traumatic injury resulted in growth arrest due to physeal bar formation and subsequent genu valgum, In this case we opted for physeal bar resection with partial physis fusion i. e.; hemiepiphysiodesis. The resultant correction was good and acceptable and hault in growth process was procured. Premature growth arrest is characterized by an unexpected discontinuation of longitudinal and/or appositional bone growth secondary to an insult to the growth plate prior to skeletal maturity. Growth arrest is frequently posttraumatic; however, other aetiologies include congenital conditions (e.g. Blount’s disease), infection, neoplasm, irradiation, metabolic/hematologic abnormalities, ischemia, disuse, and iatrogenic injury. Which ultimately results in limb length discrepency (LLD) and if present peripherally, angular deformity as well. In our case we found physical injury from central to peripheral resulting in both LLD and angular deformity. Hence we did growth modulation by resecting central to peripheral physeal bar, to maintain physeal gap fat was been used as inter-positional graft which found to be adequate and stable. Near functional correction was achieved post resection and hemiepiphysiodesis after 1 year follow up.