Clinical study of the 'U'-shaped staple-guided growth technique in the treatment of congenital anterolateral bowing of the tibia in children.

Abstract

The aim of this study was to investigate the early effectiveness of guided growth techniques for managing congenital anterolateral bowing of the tibia (ALBT) in children. A retrospective analysis was performed involving 18 patients with ALBT treated with the 'U'-shaped staple-guided growth technique between January 2020 and October 2022 at two centres. Anteroposterior and lateral radiographs of both lower limbs and the tibia as well as the fibula were collected before surgery, at the time of implant removal, or at the last follow-up. Changes in the coronal tibial diaphyseal angulation, sagittal tibial diaphyseal angulation, anatomical medial proximal tibial angle (aMPTA) and anatomical lateral distal tibial angle (aLDTA) were statistically analysed to evaluate the correction effect of the ALBT. All patients were followed up for an average of 23.36 months (range: 14.53-37.2 months). All 18 patients demonstrated an improvement in the coronal plane tibial shaft angle, with an average correction of 17.94° (range: 5.54°-33.52°). Fourteen patients displayed an improvement in the sagittal plane tibial shaft angle, with an average correction of 13.44° (range: 1.89°-32.6°). Both the aMPTA and aLDTA levels decreased after treatment. No tibial pseudarthrosis occurred in any of the 18 patients during the follow-up. The guided growth technique is effective in improving the ALBT, preventing further angular deformities of the tibia, and may delay or prevent tibial pseudarthrosis. Moreover, the guided growth technique is simple to perform, minimally invasive and associated with few complications.