ab215019

Long-term results of leg length discrepancy treated with temporary epiphyseal stapling in children with juvenile chronic arthritis

E.T. Skyttä, H.A. Savolainen¹, H.J. Kautiainen², E.A. Belt²

Surgical Department, Päijät-Häme Central Hospital, Lahti; ¹Pediatric Department and ²Orthopaedic Department, Rheumatism Foundation Hospital (RFH), Heinola, Finland.

ABSTRACT
Objective
The aim of the present study was to evaluate retrospectively the long-term efficacy of temporary stapling of the knee epiphyses over four decades of use in children with JCA.

Methods
Medical data of the patients with temporary epiphyseodesis due to leg length discrepancy (LLD) were studied. Seventeen knees in 17 patients were found with sufficient follow-up data for evaluation. Patient documents and radiographs of these patients were evaluated.

Results
The mean age at the time of the operation was 11 years (range: 6 - 15) in 3 males and 14 females. The pre-operative mean LLD was 21 mm (SD 8) and at staple removal 4 mm (SD 10). The difference was -17 mm (95 % CI: -10 to -23). Statistically the result remained the same during the follow-up. Two reversible complications were documented among the 17 stapled knees. In five (29%) cases the correction was affected by re-occurrence of LLD quickly after removal of the staples.

Conclusion
In this study with 17 patients and a wide range of follow-up times we found that the good correction of LLD achieved by stapling is usually permanent.

Key words
Juvenile chronic arthritis, leg length discrepancy, temporary epiphyseal stapling.

Please address correspondence to: Dr Eerik Skyttä, Päijät-Häme Central Hospital FIN-15850 Lahti, Finland.
E-mail: eerik.skytta@phks.fi