- [Home](https://ortopediaevolutiva.com/en) - [Pediatric Orthopaedics Blog — Dr. Priano](https://ortopediaevolutiva.com/en/blog) - Ankle Valgus in Children: Results of Guided Growth and Rebound # Ankle Valgus in Children: Results of Guided Growth and Rebound January 16, 2026 2 min read Edited and medically reviewed by [Dr. Daniele Priano](https://ortopediaevolutiva.com/en/about) ![Ankle Valgus in Children: Results of Guided Growth and Rebound](https://ortopediaevolutiva.com/blog-images/valgismo-caviglia-bambino-guided-growth-hemiepifisiodesi-tibia-neutral-v1.webp) This English version is based on the original Italian article. For wording nuances, you can refer to the Italian version. ## In short, for parents - • The child's remaining growth is used to gradually correct ankle valgus. - • Correction is slow, at around 0.6 degrees per month, and takes time to stabilise. - • Some recurrence after implant removal is possible and needs follow-up. Guided growth of the distal medial tibia allows for progressive correction of ankle valgus by utilizing residual growth. A systematic review published in 2026 collected 17 retrospective studies, involving 549 patients and 800 ankles. [1] ## Correction Speed The main radiographic parameters, including LDTA, tibiotalar tilt, and tibiotalar angle, improved after temporary hemiepiphysiodesis. The average correction speed was approximately 0.6° per month. [1] The average duration until implant removal was 18.6 months. This data is particularly useful for planning: the technique requires a sufficient amount of residual growth and regular follow-ups over time. ## What Happens After Removal The review reports an average rebound of approximately 0.3° per month after implant removal. The achieved alignment largely remained preserved, albeit with some loss of correction. [1] Therefore, monitoring does not end at the time of removal. In children with significant residual growth, it is necessary to verify that the axis remains stable and that a clinically significant recurrence does not appear. ## Complications and Reoperations In studies that reported the data, overall complications were around 11% and reoperations approximately 3.9%, predominantly due to hardware-related issues. [1] Wound issues, implant discomfort, hardware position, and timing of removal are part of the process, even if the procedure is less invasive compared to a corrective osteotomy. ## How to Use These Numbers The average of 0.6° per month does not allow for precise prediction of each child's correction speed. The etiology of the deformity, age, residual growth, and technique used all influence the outcome. However, the systematic review provides a realistic estimate of the timelines and rebound to discuss with families. Guided growth is a progressive correction and requires enough growth to complete the process. Disclaimer: this content is for informational purposes only and does not replace an individual clinical evaluation. References [1] Ashkanani M, et al. Guided Growth for Pediatric Ankle Valgus: A Systematic Review of Distal Medial Tibial Hemiepiphysiodesis (DMTH) Outcomes. J Pediatr Orthop. 2026 Jan 15. DOI: 10.1097/BPO.0000000000003219. PMID: 41537464. PubMed: [https://pubmed.ncbi.nlm.nih.gov/41537464/](https://pubmed.ncbi.nlm.nih.gov/41537464/) — DOI: [https://doi.org/10.1097/BPO.0000000000003219](https://doi.org/10.1097/BPO.0000000000003219) ## Complete pathway on growth and limb alignment This page is part of the pathway on growth and limb alignment. - [6 Axis surgery: hemiepiphysiodesis / guided growth Angular modulation of alignment: temporary hemiepiphysiodesis (guided growth) and, in rigid deformities or after growth, corrective osteotomy.](https://ortopediaevolutiva.com/en/surgery/knock-knees-bow-legs) [Discrepancy: temporary or permanent epiphysiodesis](https://ortopediaevolutiva.com/en/surgery/limb-length-discrepancy) - [Lengthening and complex correction](https://ortopediaevolutiva.com/en/surgery/limb-length-discrepancy) - [1 Knock knees and bow legs](https://ortopediaevolutiva.com/en/conditions/knock-knees-bow-legs) - [5 Lower limb length discrepancy](https://ortopediaevolutiva.com/en/conditions/limb-length-discrepancy) ![Dott. Daniele Priano](https://ortopediaevolutiva.com/assets/doctor-avatar-3d-CTvqnoPa.webp) ### Concerned about your child? If you recognize any of these signs in your child, a specialist assessment can give you clarity. I see children at Gaetano Pini and CTO institutes in Milan. 5.0 · Google & MioDottore [Book a private visit](https://ortopediaevolutiva.com/en/locations#prenota) ### Related Articles [Toe walking: when to consider surgery and what we know about recurrence in autism Read](https://ortopediaevolutiva.com/en/blog/toe-walking-when-surgery-recurrence-autism)[Children’s shoes worn on one side: what does it mean? Read](https://ortopediaevolutiva.com/en/blog/children-shoes-worn-on-one-side)[Medial malleolus fractures in children: is the risk of growth arrest really that high? Read](https://ortopediaevolutiva.com/en/blog/medial-malleolus-fractures-children-growth-arrest) ![Dott. Daniele Priano](https://ortopediaevolutiva.com/assets/doctor-avatar-3d-BiLSxBxW.webp) Author and medical reviewer ## Dr. Daniele Priano [Pediatric orthopaedic care in Milan](https://ortopediaevolutiva.com/en) — Gaetano Pini & CTO [Read full bio](https://ortopediaevolutiva.com/en/about) --- Canonical: https://ortopediaevolutiva.com/en/blog/ankle-valgus-guided-growth-correction Le informazioni cliniche sono divulgative e non sostituiscono una valutazione medica diretta.