A Method of Time Prediction in Epiphysiodesis for Limb Length Discrepancy Based On Multiplier

Overview

Journal Arch Bone Jt Surg

Date 2023 Dec 26

PMID 38146518

Authors

Reza Abdi

Omid Shahpari

Farshid Bagheri

Ramin Zargarbashi

Affiliations

Soon will be listed here.

Abstract

Objectives: The most critical step in the calculation of final limb length discrepancy (LLD) is estimating the length of the short limb after skeletal maturity(Sm). Paley's multiplier method is a fast, convenient method for calculating Sm and LLD after skeletal maturity; nonetheless, the calculation of the process of Sm and LLD in acquired type cases is complex in contrast to congenital type in this method. Notwithstanding, the multiplier method uses a variable called "growth inhibition" for the calculation process in acquired type LLD; however, its mathematical proof has not been published yet. The present study aims to find out whether there is an alternative way to estimate the length of Sm and LLD in skeletal maturity without using growth inhibition (GI) and its complex calculation process in acquired type LLD.

Methods: We used trigonometric equations to prove the GI concept and conducted proportionality analysis to calculate the length of short limbs and LLD in skeletal maturity without using GI.

Results: Based on the results, the following proportionality can estimate the length of the short limb in skeletal maturity. (ΔLm/ΔL = ΔSm/ΔS).

Conclusion: The GI concept can be proved trigonometrically; nonetheless, its numerical value is not necessary for estimating the length of the short limb in skeletal maturity. Instead, a simple proportionality analysis serves the purpose of calculation.

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Calculation of the Forearm and Hand Three-Dimensional Anthropometry Based on Two-Dimensional Image Feature Extraction: An Approach for Cock-up Splint Design.

Daliri M, Rajabi M, Rastaghi S, Ataei M, Meybodi M, Jirofti N Arch Bone Jt Surg. 2024; 12(9):622-630.

PMID: 39498225 PMC: 11531770. DOI: 10.22038/ABJS.2024.73439.3435.

References

Eltayeby H, Gwam C, Frederick M, Herzenberg J . How Accurate is the Multiplier Method in Predicting the Timing of Angular Correction After Hemiepiphysiodesis?. J Pediatr Orthop. 2018; 39(2):e91-e94. DOI: 10.1097/BPO.0000000000001278. View

Mills G, Nelson S . An improved spreadsheet for calculating limb length discrepancy and epiphysiodesis timing using the multiplier method. J Child Orthop. 2016; 10(4):313-9. PMC: 4940249. DOI: 10.1007/s11832-016-0754-4. View

MENELAUS M . Correction of leg length discrepancy by epiphysial arrest. J Bone Joint Surg Br. 1966; 48(2):336-9. View

Paley D, Bhave A, Herzenberg J, Bowen J . Multiplier method for predicting limb-length discrepancy. J Bone Joint Surg Am. 2000; 82(10):1432-46. DOI: 10.2106/00004623-200010000-00010. View

Mudgal C . Many drops make a lake. Arch Bone Jt Surg. 2014; 2(1):1. PMC: 4151437. View

Ruzbarsky J, Goodbody C, Dodwell E . Closing the growth plate: a review of indications and surgical options. Curr Opin Pediatr. 2016; 29(1):80-86. DOI: 10.1097/MOP.0000000000000438. View

Lamm B, Paley D, Kurland D, Matz A, Herzenberg J . Multiplier method for predicting adult foot length. J Pediatr Orthop. 2006; 26(4):444-8. DOI: 10.1097/01.bpo.0000226274.63083.38. View

Aguilar J, Paley D, Paley J, Santpure S, Patel M, Herzenberg J . Clinical validation of the multiplier method for predicting limb length discrepancy and outcome of epiphysiodesis, part II. J Pediatr Orthop. 2005; 25(2):192-6. DOI: 10.1097/01.bpo.0000150808.90052.7c. View

Moseley C . A straight-line graph for leg-length discrepancies. J Bone Joint Surg Am. 1977; 59(2):174-9. View

10.

Monier B, Aronsson D, Sun M . Percutaneous epiphysiodesis using transphyseal screws for limb-length discrepancies: high variability among growth predictor models. J Child Orthop. 2015; 9(5):403-10. PMC: 4619365. DOI: 10.1007/s11832-015-0687-3. View

11.

Hubbard E, Liu R, Iobst C . Understanding Skeletal Growth and Predicting Limb-Length Inequality in Pediatric Patients. J Am Acad Orthop Surg. 2019; 27(9):312-319. DOI: 10.5435/JAAOS-D-18-00143. View

12.

Makarov M, Jackson T, Smith C, Jo C, Birch J . Timing of Epiphysiodesis to Correct Leg-Length Discrepancy: A Comparison of Prediction Methods. J Bone Joint Surg Am. 2018; 100(14):1217-1222. DOI: 10.2106/JBJS.17.01380. View

13.

Anderson M, MESSNER M, GREEN W . DISTRIBUTION OF LENGTHS OF THE NORMAL FEMUR AND TIBIA IN CHILDREN FROM ONE TO EIGHTEEN YEARS OF AGE. J Bone Joint Surg Am. 1964; 46:1197-202. View

14.

Moseley C . Leg-length discrepancy. Pediatr Clin North Am. 1986; 33(6):1385-94. DOI: 10.1016/s0031-3955(16)36149-1. View