The use of bone staples to correct valgus and varus knee deformities in Caribbean children: A 30-year review.

Paediatric coronal-plane angular knee deformities are very common and should be corrected before skeletal maturity to prevent significant morbidity in adulthood. Hemi-epiphysiodesis using bone staples was traditionally used for correction, but this is now most often performed using tension band plating. However, these implants are costly and therefore we believe that there is still a role for bone staples in low- and middle-income countries (LMICs). Results of a 30-year retrospective, single-centre study of bone stapling performed for angular knee deformity correction in Trinidad showed that of 121 knees stapled, only 12 (10%) of these eventually required corrective osteotomies. Although our complication rate of 36.4% was higher than previous studies, two-thirds of these children had underlying bony pathology, which is known to increase complication rates. Physeal stapling has a proven record of successful deformity correction and remains suitable for LMICs owing to its low cost.