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PROCEDURE 29 – Epiphysiodesis of the Distal Femur/Proximal Tibia-Fibula

Samantha A. Spencer

Indications

      Leg length discrepancy (LLD) projected to be greater than 2.5 cm at the end of growth

Pitfalls

      Be sure adequate radiographs have been obtained: scanograms are inaccurate if the knee is flexed.
      Correlate age in years to bone age/Tanner stage.
      Use an accepted method to calculate the LLD at skeletal maturity (e.g., multiplier method).
      Some conditions such as infection or juvenile arthritis or trauma may cause a physis to initially overgrow then slow down again or close early: be wary of performing early contralateral epiphysiodesis in these cases.