Professor Baumgart, MD
Limb Lengthening Center Munich
Growth modulation
Leg alignment ("axis") starts as a bow-leg in infants, changes to a knock-kneed leg in growing children, and then becomes the normal straight-leg of adulthood. The deviation of the leg axis thus does not need correction at every age.
A small intervention with a big effect
If the physiological development of the leg alignment (axis) is disturbed, it is possible to stop further abnormal growth, and in many cases actually correct it, with a small surgical intervention. This is all the more important because the growing skeleton tries to compensate for faulty growth in other places, so that sections of the skeleton that are not affected at first can then also develop faulty shape. With so-called "growth modulation" (hemi-epiphysiodesis) at the right time, much larger operations can often be avoided in adulthood.
A small plate regulates the leg alignment (axis)
A distinction must be made between "growth modulation " and "growth arrest (epiphysiodesis) ". A "growth arrest " serves to prevent the longer leg from growing in the case of a leg length difference and, in our opinion, is indicated only in very rare cases. In most cases, the leg that has remained too short also has some kind of deformity, which then remains untreated, a loss of height occurs and the final result is much less accurate than if the shortened side is lengthened.
Only a small window of opportunity is open for growth modulation
Depending on which growth plate (epiphysis) is affected, a small plate can be temporarily attached to the bone. This plate blocks the growth plate on that side of the bone until the leg axis is aligned by the growth on the other side of the bone. The plate is then removed.
The time for growth modulation must be calculated precisely, as there is usually only a small window of time when this small, outpatient procedure should be performed- an opportunity for children that should not be missed if it is needed.
Cases
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