Long-Term Risks and Complications of Epiphysiodesis (Growth Plate Surgery)

Understanding Epiphysiodesis: Late Complications

Note: "Interception surgery" in the source refers to epiphysiodesis—surgical ablation of a growth plate to correct limb length discrepancy. The term "interception surgery" is nonstandard; this article uses the correct medical terminology.

Epiphysiodesis is generally safe and effective for managing limb length inequality in growing children. However, long-term complications can occur years after surgery.

Potential Late Complications

1. Chronic Pain: Persistent pain at the surgical site, possibly from hardware prominence, neuroma, or altered biomechanics.
2. Scarring and Adhesions: Soft tissue adhesions may limit joint mobility or cause discomfort.
3. Nerve Injury: Iatrogenic nerve damage during surgery can cause permanent numbness, paresthesia, or neuropathic pain.
4. Hardware Failure: Screws, plates, or staples may loosen, break, or migrate, requiring revision surgery.
5. Growth Disturbance / Angular Deformity: Incomplete or asymmetric physeal arrest can worsen limb alignment (valgus/varus) or cause recurrent length discrepancy.
6. Infection (Late): Rare but possible; may present as indolent infection around hardware.
7. Premature Joint Degeneration: Altered joint mechanics from limb length inequality or angular deformity may accelerate osteoarthritis.

Risk Modifiers

• Patient age at surgery, growth remaining
• Surgical technique (percutaneous vs. open, staple vs. screw vs. ablation)
• Surgeon experience and volume
• Compliance with postoperative protocol
• Underlying diagnosis (e.g., congenital vs. post-traumatic)

Monitoring and Management

• Regular follow-up with serial radiographs (scanograms) until skeletal maturity.
• Early detection of angular deformity or hardware issues allows timely intervention.
• Physical therapy for gait training and strengthening.
• Hardware removal if symptomatic after growth completion.

Most patients do well with appropriate selection and technique. Shared decision-making with a pediatric orthopedic surgeon is essential.