{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T03:48:18Z","timestamp":1783482498761,"version":"3.55.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,9]]},"abstract":"<jats:p>Growth modulation with tension band plates (TBP) has been shown to be a very useful method for the treatment of angular deformities in growing children. Recently, we have observed cases of failure where the epiphyseal screw was drawn through the physis into the metaphysis. This study describes a series of children who developed this complication. Patients who developed TBP failure after operative treatment of lower limb angular deformities were identified from the databases at four institutions over a 5-year period. The medical records were reviewed to record demographics, primary diagnoses, details of the operative procedure, development of physeal arrest, and recurrence of the original deformity. Six patients (five girls) with nine implant failures were identified. The mean age of the children at the time of implant insertion was 7.2 years (range, 4\u201310 years). The primary diagnoses included hypophosphatemic rickets (<jats:italic toggle=\"yes\">n<\/jats:italic>=7), congenital pseudoarthrosis of the tibia associated with neurofibromatosis 1 (<jats:italic toggle=\"yes\">n<\/jats:italic>=1), and post-traumatic malunion after distal tibial fracture (<jats:italic toggle=\"yes\">n<\/jats:italic>=1). Of the nine TBP that presented with the complication, four were inserted into the medial distal femur (one bilateral case), two into the medial proximal tibia (one bilateral case), two into the lateral distal tibia, and one into the medial distal tibia. None of these patients developed physeal growth arrest at the last follow-up as assessed on the latest radiographs. The use of TBP for guided growth in patients younger than 10 years old with rickets, neurofibromatosis, or other conditions that produce osteopenia leads to an increased risk for implant failure. In these cases, it is important to confirm that the epiphyseal screw has good purchase. Patients with these features should be monitored closely for early detection of this complication.<\/jats:p>","DOI":"10.1097\/bpb.0000000000000367","type":"journal-article","created":{"date-parts":[[2016,7,8]],"date-time":"2016-07-08T16:35:02Z","timestamp":1467995702000},"page":"449-453","source":"Crossref","is-referenced-by-count":11,"title":["Failure of tension band plating: a case series"],"prefix":"10.1097","volume":"26","author":[{"given":"Julio J.","family":"Masquijo","sequence":"first","affiliation":[{"name":"Department of Pediatric Orthopaedics, Sanatorio Allende, C\u00f3rdoba, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory B.","family":"Firth","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Chris Hani Baragwanath Academic Hospital, University of the Witwatersrand, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalia","family":"Sep\u00falveda","sequence":"additional","affiliation":[{"name":"COTI, Santiago, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20230828","doi-asserted-by":"crossref","first-page":"878","DOI":"10.1097\/BPO.0b013e318236b1df","article-title":"Guided growth for ankle valgus","volume":"31","author":"Stevens","year":"2011","journal-title":"J Pediatr Orthop"},{"key":"R2-20230828","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1097\/BPO.0000000000000116","article-title":"Medial malleolar screw versus tension-band plate hemiepiphysiodesis for ankle valgus in the skeletally immature","volume":"34","author":"Driscoll","year":"2014","journal-title":"J Pediatr Orthop"},{"key":"R3-20230828","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1097\/01241398-200201000-00025","article-title":"Natural history of multiple hereditary osteochondromatosis of the lower extremity and ankle","volume":"22","author":"Noonan","year":"2002","journal-title":"J Pediatr Orthop"},{"key":"R4-20230828","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1097\/01241398-199611000-00014","article-title":"Supramalleolar osteotomy for ankle valgus in myelomeningocele","volume":"16","author":"Abraham","year":"1996","journal-title":"J Pediatr Orthop"},{"key":"R5-20230828","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/01241398-200101000-00017","article-title":"Transphyseal osteotomy of the distal tibia for correction of valgus\/varus deformities of the ankle","volume":"21","author":"Lubicky","year":"2001","journal-title":"J Pediatr Orthop"},{"key":"R6-20230828","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1097\/01241398-199701000-00002","article-title":"Surgical management of ankle valgus in children: use of a transphyseal medial malleolar screw","volume":"17","author":"Davids","year":"1997","journal-title":"J Pediatr Orthop"},{"key":"R7-20230828","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1097\/01241398-199701000-00003","article-title":"Screw epiphysiodesis for ankle valgus","volume":"17","author":"Stevens","year":"1997","journal-title":"J Pediatr Orthop"},{"key":"R8-20230828","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1097\/BPO.0b013e318202c20e","article-title":"Temporary screw epiphyseodesis of the distal tibia: a therapeutic option for ankle valgus in patients with hereditary multiple exostosis","volume":"31","author":"Rupprecht","year":"2011","journal-title":"J Pediatr Orthop"},{"key":"R9-20230828","first-page":"E23","article-title":"Hemiepiphyseal stapling for ankle valgus in multiple hereditary exostoses","volume":"41","author":"Tompkins","year":"2012","journal-title":"Am J Orthop (Belle Mead NJ)"},{"key":"R10-20230828","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1097\/BPB.0b013e32834f0477","article-title":"Distal tibial physeal bridge: a complication from a tension band plate and screw construct. 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