Physeal Growth May Resume Following Removal of Transphyseal Epiphysiodesis Screws.

Abstract

A 14 +6 year-old (bone age 13 +0 years) genetically 46, XX, phenotypic female patient underwent distal femur and proximal tibia screw epiphysiodesis for a leg length discrepancy related to overgrowth following juvenile ACL reconstruction. The patient was considering, but had not committed to, gender affirmation treatment (internally the patient felt male). The patient later started testosterone, which altered predictions of height and leg length discrepancy at maturity. Screws were removed to minimize overshortening of the previously long leg. Upon screw removal, modest growth of the operative limb resumed. Following removal of transphyseal screws in skeletally immature patients, growth may resume.