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Arthritis und Rheuma 2017; 37(05): 307-314
DOI: 10.1055/s-0037-1618437
Kinderorthopädie
Schattauer GmbH

Möglichkeiten der Wachstums-lenkung

Prospects of growth modulation
M. Rupprecht
1   Abteilung für Kinderorthopädie, Altonaer Kinderkrankenhaus, Hamburg
2   Klinik für Orthopädie, Universitätsklinikum Hamburg Eppendorf, Hamburg
,
K. Ridderbusch
1   Abteilung für Kinderorthopädie, Altonaer Kinderkrankenhaus, Hamburg
2   Klinik für Orthopädie, Universitätsklinikum Hamburg Eppendorf, Hamburg
,
A. S. Spiro
1   Abteilung für Kinderorthopädie, Altonaer Kinderkrankenhaus, Hamburg
2   Klinik für Orthopädie, Universitätsklinikum Hamburg Eppendorf, Hamburg
› Author Affiliations
Further Information

Publication History

Publication Date:
28 December 2017 (online)

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Zusammenfassung

Klassiker der Wachstumslenkung ist die Blountklammerepiphyseodese bei zugrunde liegendem X- oder O-Bein. Mittlerweile existiert eine deutlich größere Bandbreite, die Indikationen reichen von posttraumatischen Achsdeformitäten der Arme, über den juvenilen Hallux valgus bis hin zur kindlichen Skoliose. Grundvoraussetzung jeder wachstumslenkenden Therapie ist ein ausreichendes Restwachstum. Um den bestmöglichen Zeitpunkt der Therapie festzustellen, müssen exakt das Ausmaß der Deformität und das sogenannte Skelettalter des Patienten bekannt sein. Wird die Epiphyseodese zu früh vorgenommen, also sind die Wachstumsfugen nach erfolgter Korrektur und Material-entfernung noch weit offen, kann es zu einem Rebound der Deformität kommen. Wird der Eingriff zu spät durchgeführt, reicht das Restwachstum nicht aus, die Deformität vollständig zu korrigieren.

Summary

Indications for an epiphyseodesis vary from knock knees, posttraumatic deformities of the upper extremity, juvenile hallux valgus to early onset scoliosis. Prerequisite for a successful therapy is residual growth. To determine the best time of epiphyseodesis, the extent of the deformity and the skeletal age of the patient must be known. If the epiphyseodesis is performed too early, the epiphy-seal plates are still wide open after fully correction and hardware removal, a rebound of the deformity may occur. If the intervention is carried out too late, the residual growth is not sufficient to completely correct the deformity.

Schlüsselwörter

Wachstumslenkung - Epiphyseodese - Skelettalter

Keywords

Growth modulation - epiphyseodesis - skeletal age
 

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