Functional and Radiological Outcome of Hemiepiphysiodesis in Children With Rickets-Associated Genu Valgum: A Retrospective Study

Background: Genu valgum is a common residual deformity in children with rickets despite optimal medical management. Temporary medial hemiepiphysiodesis using tension-band plates offers a minimally invasive means of guided correction in the growing skeleton. We evaluated the functional and radiological outcomes of this technique in rickets-associated genu valgum and assessed factors associated with rebound. Methods: We retrospectively reviewed 34 children (58 knees) treated with tension-band plate hemiepiphysiodesis for symptomatic rickets-related genu valgum between 2017 and 2022, with a minimum follow-up of 24 months. Tibiofemoral angle, mechanical axis deviation, joint orientation angles, intermalleolar distance, pain, satisfaction and a composite functional grade were analysed. Results: The mean tibiofemoral valgus improved from 18.4° to 5.6°, mechanical axis deviation from 29.6 mm to 6.2 mm and intermalleolar distance from 9.1 cm to 1.8 cm (all P < 0.001). An excellent or good functional grade was achieved in 50 of 58 limbs (86.2%). Rebound after implant removal occurred in 9 of 49 limbs (18.4%) and was significantly more frequent in children younger than  10years. Conclusion: Tension-band hemiepiphysiodesis is a safe and effective treatment for rickets-associated genu valgum, yielding favourable radiological and functional outcomes, with rebound the principal concern in younger children.