Guided growth helps in the correction of knee deformity in p
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Orthopedic manifestations of congenital insensitivity to pain (CIP) can be devastating if left untreated. Knee deformities are common in patients with CIP and might lead to joint destruction and loss of walking ability. The purpose of the present study was to report the results and complications of guided growth procedures around the knee in patients with CIP.

In a retrospective review, all patients with CIP who underwent guided growth procedures around the knee at a tertiary referral hospital were evaluated. Patients with secondary insensitivity to pain (e.g., syringomyelia), as well as patients with incomplete records, were excluded. Demographic data, clinical findings, correction rate, and complications were recorded.

Results:
--10 knees in 6 patients fulfilled the inclusion criteria.
--The median age was 10, with a mean follow-up of 31 months.
--Distal femoral tension-band hemiepiphysiodesis was the most common procedure, followed by proximal tibial hemiepiphysiodesis.
--The mean correction rate was 0.28°/month for femoral deformity. Staples were removed prematurely in 1 patient due to extrusion.
--No cases of infection or skin dehiscence were observed.
--None of the patients needed a reconstructive knee procedure during the study period.

According to the findings of this report, directed growth procedures can play a role in the correction of knee deformities in CIP patients. However, since the correction rate is lower than that of normally developing children, patients should be closely monitored to avoid complications, and patients should be selected using strict criteria to ensure success.

Source: https://josr-online.biomedcentral.com/articles/10.1186/s13018-021-02304-w
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