Growth Guidance Systems
Growth Guidance Systems in Pediatric Orthopedics
Growth guidance systems represent a revolutionary approach in pediatric orthopedics, designed to harness and direct natural growth patterns to correct skeletal deformities while maintaining spinal mobility and function.
Key Concepts
- Non-fusion technology that allows continued skeletal growth
- Dynamic correction of deformities through guided growth
- Reduced need for repeated surgical interventions
- Preservation of spinal mobility and function
Primary Indications
- Early-onset scoliosis (EOS)
- Progressive spinal deformities
- Congenital vertebral anomalies
- Neuromuscular scoliosis
Basic Principles
Biomechanical Foundations
- Utilization of Hueter-Volkmann principle
- Growth modulation through mechanical loading
- Maintenance of growth plate function
- Dynamic response to skeletal development
Growth Modulation Mechanisms
Growth guidance systems work through several key mechanisms:
- Controlled mechanical stress application
- Gradual deformity correction
- Preservation of growth plate activity
- Maintenance of spinal mobility
Types of Growth Guidance Systems
Modern Systems
- Shilla Growth Guidance System
- Non-locking sliding screws
- Allows for cranial and caudal growth
- Reduced need for lengthening procedures
- Luque Trolley
- Sublaminar wiring technique
- Sliding rod construct
- Growth-accommodating design
- Modified Luque-Trolley
- Enhanced stability features
- Improved sliding mechanics
- Better growth accommodation
Clinical Applications
Patient Selection Criteria
- Age considerations (typically 5-10 years)
- Curve progression patterns
- Growth potential assessment
- Underlying pathology evaluation
Surgical Considerations
Critical factors in surgical planning include:
- Strategic anchor point selection
- Rod configuration optimization
- Growth potential preservation
- Complications management strategy
Patient Monitoring
Follow-up Protocol
- Regular radiographic assessment (3-6 monthly)
- Growth velocity monitoring
- Deformity correction evaluation
- Implant integrity checking
Potential Complications
- Rod migration or prominence
- Hardware failure
- Infection risks
- Growth disturbance
Disclaimer
The notes provided on Pediatime are generated from online resources and AI sources and have been carefully checked for accuracy. However, these notes are not intended to replace standard textbooks. They are designed to serve as a quick review and revision tool for medical students and professionals, and to aid in theory exam preparation. For comprehensive learning, please refer to recommended textbooks and guidelines.
