Medial malleolar screw hemiepiphysiodesis for ankle valgus in children with spina bifida

Published online: Sep 27 2014

Ilhan A. BAYHAN, Timur YILDIRIM, Kubilay BENG, Cagri OZCAN, Aysegul BURSALI

From the Metin Sabanci Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey


Medial malleolar screw hemiepiphysiodesis has been shown to be an effective procedure for the treatment of ankle valgus in children with spina bifida. The purpose of this study was to highlight the guided growth technique and discuss its efficacy. We retrospectively reviewed 10 spina bifida patients with 18 ankle valgus deformities treated with medial malleolar screw hemiepiphysiodesis. Medical reports were obtained to document age at surgery, gender, concurrent operative procedures and postoperative early and late complications. Anteroposterior and lateral weight bearing radiographs of both ankles were evaluated using the tibiotalar angle, pre and postoperatively. The average age at operation was 10,05 years. Average follow up was 15,33 months (11-21 months). During follow-up, the average preoperative distal tibiotalar angle of 16.27 degrees improved to an average of 2,88 degrees with statistical significance (p < 0,05). No major complications were detected. In conclusion, hemiepiphysiodesis is a safe and sufficient method to correct ankle valgus deformity in children with spina bifida, with a low incidence of complications and satisfactory results.