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Abstract
The growth plate (the physis) has a unique structure. Its formed of cartilaginous, fibrous, and metaphyseal bony parts. The cartilaginous part is formed of three zones: the reserve zone, the proliferative zone, and the hypertrophic zone. The huter-volkmans low for the growth plates, states that increasing compression across a growth plate leads to decreasing growth. Most of the longitudinal growth of the lower limb occurs at the distal femoral and proximal tibial physes. Stopping the growth of these physes means stopping the lower limb from normal increase in length. Lower limb have specific orientations, these orientations can be assessed using anatomical axis, mechanical axis, and different joint orientation angles. The under standing of these axis’s and angles is essential for evaluating any angular deformity in the lower limb, as well as planning for the right option of treatment. Correcting angular deformities around the knee can be done in skeletally immature patients by unilateral hemiepiphysiodesis.
Many techniques of hemiepiphysiodesis have been described in the literature.
These range from phemister open technique, stapling epiphysiodesis, percutaneous epiphysiodesis and percutaneous epiphysiodesis using transphyseal screws, and more recently the use of a non-locking extraperiosteal 8 plate (guided growth).