Guided growth refers to a surgery done in children to correct deformities like knock knees or bowed knees by taking advantage of their still-growing bones to correct as they grow taller.
Other names commonly used in place of guided growth surgery are 8-plate surgery, hemiepiphysiodesis, and tension plate surgery.
This surgery is only possible in children who still have growth potential meaning that their growth plates are still open.
Guided growth surgery is essentially possible on any bone with a growth plate but is most commonly used around the knee joint to correct knock knees and bowed knees.
This article summarises what is generally expected after your child has undergone hemiephysiodesis.
The image below demonstrates what knocked knees and bowed legs look like in comparison to normal knees.
What is done in 8-plate surgery?
The guided growth surgery will typically involve placing a plate and screws adjacent to the growth plate to halt the progression of the deformity while the rest of the growth continues with a corrected alignment as the end result.
Walking after surgery.
Your child is allowed to walk immediately following surgery as much as is tolerated. They may feel a bit sore but this should easily be taken care of by some over-the-counter pain medication.
The child may need crutches during the first few weeks in case they are too sore at the knees to walk unsupported.
Bathing after surgery
You may have a waterproof dressing to keep the wound dry. Normally you are allowed to bathe after 3days. In the 1st 3days, you are allowed to sponge bath and keep the dressing dry.
The dressing should be removed by your nurse or doctor typically in about 2 weeks.
Do I need crutches after the surgery?
It would be nice to have the crutches and use them if the need arises but most children don’t necessarily need the crutches especially if the pain is well controlled.
Involvement in sports after hemiepiphysiodesis
After the soreness has eased, children are encouraged to stay as active as they like. The presence of metallic implants is not in any way a contraindication to any sport. Children can return to sports after 3 weeks.
When are the implants removed?
The implants will be removed when you have fully corrected the alignment of your bones. In some cases, the implants can be left in a little longer in order to overcorrect the angulation and reduce the risk of early rebound of the deformity.
Contraindications to 8-plate surgery
8-plate surgery shouldn’t be done in children with closed growth plates and in adults.
What is rebound of the deformity?
Rebound refers to the recurrence of the original bowing or knocking of the knees after surgical removal of the plate.
Sometimes this is anticipated and so your doctor may take out only one screw and leave the other in place so that if rebound occurs, it is easier to reinsert the screw.
In conclusion, guided growth is surgery done to correct deformities in children’s bones by taking advantage of their growth potential hence correcting as they grow taller.
A small plate will be placed on the bone and it is often removed when the bone is done correcting.
