Idiopathic genu valgum is a frequently diagnosed growth disorder in adolescence. Whenever the possibilities of conservative therapy have been exhausted, leg straightening by means of hemiepiphysiodesis has become the standard form of treatment. Because of their flexible screw-plate connection, eight-Plates have been reported in the literature to lead to lower complications regarding implant loosening and fracture compared to other implants. The aim of this retrospective survey was to analyse our own patient population who were treated for genu valgum by means of temporary hemiepiphysiodesis near the knee using eight-Plates to modulate growth. Between July 2007 and July 2015, 198 eight-Plates were implanted near the knee in 132 children suffering from genu valgum to modulate growth. Depending on the deformity analysis, an eight-Plate was implanted on the distal medial femur and/or the proximal medial tibia. By December 2015, they had been removed from 105 patients. The etiology of genu valgum was mainly idiopathic or associated withobesity. Evaluation was carried out clinically and radiologically (whole-leg X-ray in standing) including determination of the joint angles. The median follow-up period was about 46 months (12–102 months). The median age at implantation was 12.7 +/−6.76 years. Of the 105 patients, 45.7% (n = 48) were girls. The eight-Plates remained in place for a median period of 13 +/−1.76 months. Irrespective of the location of hemiepiphysiodesis, the intermalleolar distance was corrected to a median of 0 +/−2.1 cm while the anatomical femorotibial angle was corrected by on average 9 +/−2.7 °Mechanical lateral distal femoral angle changed an average 7 +/− 7.72 degrees. Medial proximal tibial angle changed an average 4 +/− 6.02 degrees. Complications necessitating surgery occurred in 2.8% of cases (1 wound infection, 3 corrective osteotomies following overcorrection). Temporary hemiepiphysiodesis using eight-Plates is a gentle, simple and effective procedure used to treat genu valgum by modulating growth. Slight overcorrection is desirable due to the rebound phenomenon, especially in young patients with high growth potential and risk groups such as obese children. In adolescents with only low growth potential (older than 14 years), owing to the low correction potential, the indication should be strictly reviewed and the possible failure of therapy should be discussed with the patient. No differences were observed regarding the location of the implanted eight-Plates (femoral or tibial).

Zusammenfassung: Am Fallbeispiel eines 12-jährigen Mädchens wird die Diagnose und Therapie einer idiopathischen Chondrolyse der Hüftgelenke beschrieben. Die Patientin stellte sich mit intermittierenden Schmerzen und hochgradigen Funktionsstörungen beider Hüften vor. Nach klinischer Untersuchung und Beckenübersichtsröntgenaufnahme zeigte die MRT die typischen Veränderungen einer idiopathischen Chondrolyse. Die rein konservative Therapie mit einer konsequenten physiotherapeutischen Behandlung und regelmäßigen Einnahme eines nichtsteroidalen Antirheumatikums hat ein gutes klinisches Ergebnis erbracht.

With an incidence of 0.3 per 100,000, spondylodiscitis is a rare condition in children. It is typically bacterial in origin and most commonly caused by Staphylococcus aureus. Bone involvement in cat-scratch disease (CSD) due to Bartonella henselae is exceedingly rare, occurring in only 0.17–0.27% of cases. We present the case of a 3-year-old boy with a two-week history of intermittent back pain and a recent onset fever. Initial laboratory findings were unremarkable, and MRI revealed spondylodiscitis at L3/4 without abscess formation. Empirical antibiotic treatment with ampicillin/sulbactam showed no clinical response. Serologic testing revealed a positive Bartonella henselae IgM (IgG negative), leading to a change in antibiotic treatment to azithromycin and rifampicin for three weeks, resulting in rapid clinical improvement. Follow-up at nine weeks showed marked clinical and radiologic improvement. Although IgM subsequently turned negative without IgG seroconversion—a pattern previously described in Bartonella infections—this does not exclude the diagnosis. Biopsy or tissue PCR was not performed due to the mild clinical course. A review of the literature identified 28 pediatric cases of Bartonella henselae spondylodiscitis, with significant variation in diagnostic and treatment approaches. This case underscores the importance of considering Bartonella in the differential diagnosis of pediatric vertebral osteomyelitis.

Background/Objectives: Valgus deformities of the knee and ankle are frequently diagnosed during adolescence. Hemiepiphysiodesis (HED) using the tension-plate technique has become the standard approach for guided growth in both joints. Notably, valgus deformities may simultaneously affect both joints. While substantial data supports monoarticular guided growth, evidence for ipsilateral biarticular growth modulation remains limited. The aim of this case series was to evaluate the feasibility, safety and short-term radiographic outcome of simultaneous ipsilateral biarticular HED for concomitant valgus deformities in the knee and ankle (CKAVD). Methods: This retrospective monocentric observational study included 21 legs from 21 consecutive children treated with simultaneous ipsilateral biarticular HED for CKAVD between 2013 and 2022. The initiation and termination of growth modulation were based on clinical (intermalleolar distance, pain in both joints) and radiological parameters. Standing whole-leg coronal plain radiographs were evaluated at the start of modulation and after complete hardware removal, assessing the anatomical femorotibial angle (aFTA), anatomical lateral distal femoral angle (aLDFA), medial proximal tibial angle (MPTA), and lateral distal tibial angle (LDTA). Results: The mean age at implantation was 11.5 years (SD 1.08); females (n = 7) were younger than males (n = 14, p < 0.05). The mean duration of growth modulation was 14.3 months (SD 4.3). The intermalleolar distance improved by an average of 10 cm (SD 4.4). The aFTA improved by an average of 6.9 degrees (SD 2.6), the aLDFA by 6.7 degrees (SD 2.7), the MPTA by 7.2 degrees (SD 2.3), and the LDTA by 7.1 degrees (SD 3.0). Two-stage hardware removal was required in 6 legs (29%). In one case, a relapse of knee valgus occurred. Conclusions: Comprehensive evaluation of all major joints seems to be crucial during the diagnostic workup for coronal plane deformities of the lower extremity. For children with ipsilateral symptomatic CKAVD, simultaneous biarticular HED may be considered as a feasible treatment approach, demonstrating promising short-term outcomes and a low observed complication rate.