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. 2024 Apr 13;16(4):e58169.
doi: 10.7759/cureus.58169. eCollection 2024 Apr.

An Innovative Plate Concept for Rotational Guided Growth: A Porcine Pilot Study

Ahmed A Abood  1   2 , Jan D Rölfing  1 , Ahmed Halloum  3 , Steffen Ringgaard  4 , Jeppe S Byskov  5 , Søren Kold  3 , Ole Rahbek  3
Affiliations

An Innovative Plate Concept for Rotational Guided Growth: A Porcine Pilot Study

Ahmed A Abood et al. Cureus. .

Abstract

Background Rotational deformities in children are currently treated with an osteotomy, acute de-rotation, and surgical fixation. Meanwhile, guided growth is now the gold standard in pediatric coronal deformity correction. This study aimed to evaluate the feasibility of a novel implant intended for rotational guided growth (RotOs Plate) in a large porcine animal model. Methodology A submuscular plate was inserted on the medial and lateral aspect of the distal femoral physis of the left femur in 6 pigs. Each plate was anchored with a screw in the metaphysis and epiphysis respectively. The plates were expected to rotate the femur externally. The right femur acted as a control in a paired design. The animals were housed for 12 weeks after surgery. MRI scanning of both femora was performed before euthanasia after 12 weeks. Rotation was determined as the difference in the femoral version on MRI between the operated and non-operated femur after 12 weeks. Results External rotation in all operated femurs was observed. The mean difference in the femoral version on MRI between operated and non-operated femurs was 12.5° (range 9°-16°). No significant changes in axial growth were detected. Conclusions This study shows encouraging results regarding rotational guided growth, which may replace current invasive surgical treatment options for malrotation in children. However, further studies addressing potential secondary deformities are paramount and should be carried out.

Keywords: 3d print; guided growth; innovative implant; maltorsion; rotational deformity.

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Conflict of interest statement

RotOs Plate TM is patented by the Danish Region of Northern Jutland/Region Nord Denmark (public Danish region) and the inventor of the plate design and concept is Ahmed A. Abood who is an author of this paper.

Figures

Figure 1
Figure 1. Intraoperative images.
Intraoperative fluoroscopic images showing the insertion of the RotOs Plates in the porcine femur. Each plate is anchored with two 4.5 mm cannulated screws (DePuy Synthes): (A) coronal plane and (B) sagittal plane.
Figure 2
Figure 2. RotOs Plate.
RotOs Plate concept plate with two sliding holes for screw fixation and two Kirschner-wire (K-wire) slots for temporary intraoperative fixation.
Figure 3
Figure 3. MRI image of the femoral neck in the operated and non-operated femur with both femoral condyles aligned parallel to the scanning table showing the difference in femoral anteversion: L, left operated femur; R, right non-operated femur.
Figure 4
Figure 4. Differences in clinical rotation of the hind limbs are shown in a clinical image obtained on the leveled table.
Figure 5
Figure 5. Rotational difference of the distal femur on MRI: (A) left operated femur and (B) right non-operated femur.
MRI images of the distal femora in the operated and non-operated femur showing the difference in the femoral version. For illustrational purposes, both femoral necks are aligned parallel to the axis of the table revealing the difference in the distal femur.
See this image and copyright information in PMC

References

    1. Derotational femoral osteotomy technique with locking nail fixation for adolescent femoral antetorsion: surgical technique and preliminary study. Pailhé R, Bedes L, Sales de Gauzy J, Tran R, Cavaignac E, Accadbled F. J Pediatr Orthop B. 2014;23:523–528. - PubMed
    1. Femoral derotation for increased hip anteversion. A new surgical technique with a modified Ilizarov frame. Moens Moens, P.; Lammens, J.; Molenaers, G.; Fabry, G G. https://doi.org/10.1302/0301-620X.77B1.7822363. J Bone Joint Surg Br. 1995;77:107–109. - PubMed
    1. A review for pediatricians on limb lengthening and the Ilizarov method. Herbert AJ, Herzenberg JE, Paley D. Curr Opin Pediatr. 1995;7:98–105. - PubMed
    1. Common rotational variations in children. Lincoln TL, Suen PW. J Am Acad Orthop Surg. 2003;11:312–320. - PubMed
    1. Advances in management of limb length discrepancy and lower limb deformity. Friend L, Widmann RF. Curr Opin Pediatr. 2008;20:46–51. - PubMed

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