Case Report: Clinical effect of eight plate epiphyseal block on leg length discrepancy in children: a retrospective study of 6 typical cases

Objective This study aimed to investigate the clinical effect of epiphyseal block in treating children with LLD. Methods The clinical data of 6 children with LLD who underwent epiphyseal block treatment in our hospital from March 2017 to April 2023 were collected and analyzed, including the preoperative and postoperative changes in the length of femur and tibia measured by full-length standing x-rays of both lower limbs, and the improvement of the unequal length of limbs after epiphyseal block using the “8” steel plate was understood and summarized. Treatment outcomes were descriptively evaluated according to the reduction in LLD, residual discrepancy after treatment, and treatment-related complications. Final residual LLD was classified as satisfactory correction (<15 mm), partial correction (15–20 mm), or limited correction (>20 mm). Results The six patients (all male, aged 4–12 years, mean 7.83 ± 2.64 years) were treated for 12–45 months (mean 33.67 ± 11.91 months). Mean LLD decreased from 29.67 ± 7.76 mm preoperatively to 15.67 ± 9.42 mm after implant removal. No major complications occurred. Implant-related issues were managed differentially: loosening by hardware exchange; valgus by removing the lateral plate (retaining the medial); varus by removing the medial plate (retaining the lateral); retained hardware was removed after subsequent axis correction. Conclusion Eight-plate epiphysiodesis is not a one-stage cure for pediatric LLD; larger discrepancies require longer treatment with more variables. Nevertheless, its minimally invasive nature makes it worthwhile with rigorous preoperative evaluation, skilled surgery, and close follow-up. Crucially, complications like loosening and axis deviations demand distinct management strategies to optimize outcomes.