PENCAS: A Novel Minimally Invasive Epiphysiodesis Technique

Introduction: Epiphysiodesis is a surgical technique widely used for the management of limb length discrepancies in pediatric patients. The procedures can be theoretically reversible, using staples, transphyseal screws or Tension band plate constructs. Definitive techniques include Phemister procedure or a less invasive percutaneous drilling. We introduce a new minimally invasive technique, PENCAS (percutaneous epiphysiodesis with non-absorbable suture and cannulated screws), offering a cost-effective, reversible, and simple alternative for growth modulation. Materials and Methods: We describe a novel technique that minimizes surgical morbidity while maintaining effectiveness in controlling physeal growth. It consists of 4 cannulated 4.5 screws and a double-strand of nonabsorbable FiberWire suture (gauge #2). Results: Compared with most current methods, this technique minimized surgical dissection and reduces postoperative pain. There is minimal scaring. Beside that, it has the potential for reversal, making this technique an attractive alternative to treat limb length discrepancies. This method can also be applied to proximal tibia, where other minimally invasive methods have a higher rate of complications. Further studies are needed to validate long-term efficacy and safety.