Percutaneous Anterior Distal Femoral Hemiepiphysiodesis Using Simultaneous Biplanar Fluoroscopy Master's Surgical Technique

Abstract

Knee flexion contracture is a common target for surgical treatment in children with cerebral palsy.  Anterior distal femoral hemiepiphysiodesis (ADFH) with percutaneous screws is an alternative technique to tension-band plate and screw constructs. The technique can be demanding and correct screw placement is highly reliant on accurate intraoperative imaging. We describe a technique for ADFH using percutaneous cannulated screws with utilization of simultaneous biplanar fluoroscopy to facilitate efficient and accurate screw placement. The indications, technique, postoperative treatment, and pitfalls of this procedure are reviewed.