ESPE2022 Rapid Free Communications Growth and Syndromes (6 abstracts)
Background: Treatment options in extremely tall adolescents are limited. Bilateral epiphysiodesis has been reported to be a safe and effective method to reduce predicted final height. However, there is still limited data on final height and long-term safety.
Objective: The aim was to assess the safety and efficacy of bilateral epiphysiodesis to reduce adult height in adolescent girls and boys with extreme tall stature.
Methods: The study includes 72 patients who presented to the Pediatric Endocrine Clinic at the Karolinska University Hospital, Stockholm (Sweden) and subsequently were subjected to bilateral epiphysiodesis (girls n=45, boys n=27). Final height predictions (PFH) were based on hand x-rays before the surgery.
Results: When compared to PFH, final height (FH) was significantly reduced in both girls and boys treated with epiphysiodesis surgery (Table). The calculated height reductions correspond to 26 ± 2.9% (girls) and 40.5 ± 3% (boys) of the predicted remaining growth at the time of surgery. A negative correlation was observed between bone age at the time of surgery and absolute height reduction. This correlation was higher in boys (r=-0.63, p<0.001) than in girls (r=-0.44, p<0.001). Postoperative pain with a duration of less than 2 weeks was present in 38% (n=25) of the patients. Other complications were rarely seen.
|CA at op (yrs)||BA at op (yrs)||Height at op (cm)||PFH at op (cm)||FH (cm)||PFH-FH (cm)|
|Females (n=45)||12.3 ± 0.2||12.1 ± 0.1||175.7 ± 0.6||188.9 ± 0.5||185.3 ± 0.5*||3.6 ± 0.4|
|Males (n=27)||13.7 ± 0.2||13.6 ± 0.1||188.4 ± 1.1||208.4 ± 0.9||199.9 ± 0.9*||8.6 ± 0.9|
|Chronological age (CA), bone age (BA), predicted final height (PFH) at operation and final height (FH). Data is presented as mean ± SEM. Statistics: t-test was applied in males (normal distribution) and Wilcoxon rank test in females (non-normally distributed). *p<0.001 vs PFH at op|
Conclusion: Bilateral epiphysiodesis is an efficient and safe method to reduce final height in extremely tall adolescents. The surgery was more efficient in boys than in girls and when performed at an earlier bone age.
15 Sep 2022 - 17 Sep 2022