Stapling of the epiphysis to the diaphysis on the medial aspect of the lower end of the femur and the upper end of the tibia has been shown to correct valgus deformities of the knees in 3 children with juvenile chronic polyarthritis, whose growth had been considerably retarded during prolonged corticosteroid therapy. Satisfactory correction was obtained in all 3 without loss of function.
We stress the need for supervision in the immediate post-operative period, as well as later, since over-rapid correction of the deformity may occur during the growth spurt after stopping corticosteroid therapy, requiring removal of the staples after a few months. To obtain similar correction in those whose growth rate is slower, the staples should be left in situ for longer.