CPT® Code 27734

1. Indications

The procedure of epiphyseal arrest is indicated for specific conditions related to bone length discrepancies. These include:

• Bone Length Discrepancy The primary indication for performing epiphyseal arrest is to correct a significant difference in length between the lower legs, specifically between the tibia and fibula.
• Growth Plate Abnormalities Conditions that affect the growth plates, leading to uneven growth of the bones, may necessitate this procedure to ensure proper alignment and function of the lower extremities.

2. Procedure

The procedure of epiphyseal arrest involves several critical steps to ensure successful outcomes. These steps include:

• Step 1: Incision The surgeon begins by making a precise incision over the distal aspect of the tibia and/or fibula. This incision is strategically placed to provide optimal access to the growth plate while minimizing damage to surrounding tissues.
• Step 2: Dissection of Soft Tissues Following the incision, the surgeon carefully dissects the soft tissues to expose the underlying bone structures. During this step, great care is taken to protect important blood vessels and nerves that are located in proximity to the surgical site.
• Step 3: Exposure of the Distal Tibia and Fibula Once the soft tissues are adequately dissected, the distal tibia and/or fibula are exposed. This exposure is crucial for the subsequent placement of devices that will arrest bone growth.
• Step 4: Placement of Devices The surgeon then strategically places devices such as Blount staples, transphyseal screws, or a plate and screw device within the epiphysis of the distal tibia and/or fibula. These devices are designed to temporarily halt the growth of the bone, thereby addressing the length discrepancy.

3. Post-Procedure

After the completion of the epiphyseal arrest procedure, specific post-operative care is essential for optimal recovery. Patients are typically monitored for any signs of complications, such as infection or improper healing. Pain management strategies are implemented to ensure patient comfort. Additionally, follow-up appointments are scheduled to assess the healing process and the effectiveness of the growth arrest. Rehabilitation may be recommended to restore mobility and strength in the affected limb, depending on the individual patient's needs and the extent of the procedure performed.