Stress Strain State of the Proximal Tibia in a Child with Tibia Vara Using Unilateral Hemiepiphysiodesis with Different Types of Devices

S.O. Khmyzov, D.V. Prozorovsky, I.A. Subbota, D.V. Yershov

Abstract


Background. The current standard of pediatric frontal knee deformities treatment is a guided growth technique. Several devices are used for temporal growth plate blocking: Blount staples and different plates with screws. Up to now there is no any research devoted to stress-strain state analysis of the epimetaphyseal part of the pediatric bone with one side temporal growth plate block on it.
Objective. To study the stress-strain state of the pediatric proximal tibia model with lateral hemiepiphysiodesis using different types of devices in loading conditions typical to the tibia vara.
Materials and methods. 3D models of the proximal child’s tibia with lateral hemiepiphysiodesis using Blount staples or locking or non-locking plate were analyzed in a load conditions typical to tibia vara by finite element method using Solid Works program.
Results. Increased compressive stress was found in the medial part of the proximal tibial growth plate in load conditions typical to tibia vara. New areas of high stress in the metaphyseal bone below growth plate were deteced. The maximum stress was registered in lockers noted in the contact area of the proximal screws to the plate, and in the upper part of the Blount staples.
Conclusion. Varus deformity of the proximal tibia leads to higher compressive stress in the medial part of the proximal tibial growth plate. Lateral hemiepiphysiodesis of the proximal tibial growth plate using different types of lockers leads to different pattern of stress strain state of proximal tibial epimetaphysis. Minimal load increase in metaphysis bone tissues is observed if locking plates are used, Blount staples application causes significant enhance of load in bone tissue in its place.


Keywords


guided growth; finite element method; Blount staples; 8-plate

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DOI: https://doi.org/10.22141/1608-1706.1.17.2016.74215

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