The bones of the legs and arms get longer from growth plates, or physes. These are present at the ends of each bone, and once a person is fully grown, they disappear. These growth plates are where a “growth spurt” occurs.

If a bone is still growing, and we want to change the overall shape or length of it, it is sometimes possible to ‘guide’ or ‘encourage’ the bone to grow in a certain way. This is called ‘guided growth’ .

If we want to slow a bone down while it is growing, so that another bone (or the other leg) can ‘catch up’, we can do an operation called an epiphysiodesis. In this operation, a very small cut is made in the skin, just big enough to put a drill in and drill a growth plate. This stops the bone growing any more, from that growth plate. The operation itself is very simple and there is a quick recovery. The main thing that is tricky is timing exactly when to do the operation, so that they other leg may ‘catch up’ the right amount. Luckily we have many graphs and charts available to help us predict the best moment to operate.

If a bone is bent, we can sometimes insert a small plate with two screws, called an “8-Plate”, that restricts one side of a growth plate. As the other side of the growth plate keeps growing, the bone grows in a way that can correct the shape problem or deformity that is present. It is important to keep watching the bone (usually with x-rays) every 3 or 6 months, so that the plates can be removed at the right time, otherwise the bone will overcorrect.

Correcting a bone by guided growth is a smaller operation with a quicker recovery than having to cut a bone and realign it (osteotomy).

Download The RCH Guided Growth Info Sheet here.