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Epiphysiodesis is a surgical procedure designed to arrest the growth of a long bone in the body, typically performed on children and adolescents whose growth plates (epiphyseal plates) are still open. This operation is aimed at correcting limb length discrepancies or deformities, mainly to prevent further growth of the longer limb to enable better functional equality between limbs. The procedure involves the removal or alteration of some of the bone at the growth plate, effectively reducing its capacity for growth. The growth plate itself is a crucial area of developing tissue at the end of long bones; it is responsible for longitudinal growth during childhood and adolescence. When a child or adolescent has a significant difference in leg length due to conditions such as congenital limb deficiencies, trauma, or certain diseases, epiphysiodesis can be a valuable option. The most common indication for this procedure is to handle discrepancies greater than two centimeters that could cause functional issues or gait abnormalities. There are various surgical techniques employed in epiphysiodesis, including the use of staples, screws, or even through techniques such as percutaneous growth plate cauterization. The choice of method can depend on the age of the patient, the expected discrepancy, and the surgeon's preference. After the procedure, the growth arrest will not be immediate; it may take several months for the opposite limb to stop growing naturally to achieve the desired balance. Importantly, this procedure is typically performed on children who still have significant growth remaining, as it can otherwise result in complications such as overcorrection. Post-operative care usually involves monitoring the patient for any signs of complications, such as infection or issues resulting from the surgical intervention. Physical therapy may also be recommended to help regain strength and function in the affected limb. As with any surgery, epiphysiodesis carries risks, including the potential for nonunion, malunion, or disturbance of adjacent structures. Thus, a careful pre-operative assessment is necessary to weigh the potential benefits against these risks. Ultimately, when performed in appropriate candidates, epiphysiodesis can significantly improve the quality of life for children facing limb length discrepancies, allowing them to engage more fully in daily activities and reducing discrepancies that may lead to long-term orthopedic issues. Regular follow-ups post-surgery are crucial to ensure that the desired outcomes are achieved and to monitor growth in the remaining limb, as well as to assess for any additional orthopedic concerns that may arise as the child continues to grow and develop. This procedure stands out as a practical approach to handling issues related to lateral symmetry and limb proportions in a growing child, supporting their health and physical development into adulthood.
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