This thesis investigates an innovative approach to treating rotational
deformities in children's long bones. While many such deformities resolve
on their own, persistent cases can cause pain, instability, and
gait issues. Traditional correction involves osteotomies—major surgical
procedures. However, guided growth, a less invasive technique
already used to correct angular deformities, offers a promising alternative.

Rotational guided growth is a novel concept in which tethers are
placed across the growth plate at an angle to induce gradual rotation
during natural bone growth. The research comprised a scoping review
and two preclinical studies using a pig model.

• Study I mapped existing research, identifying 14 studies with
  varying methods and outcomes, highlighting a lack of standardization
  in the field.
• Study II tested a rigid, z-shaped titanium plate (Rotos
  Plate™) in a porcine model
• Study III evaluated flexible tethers in a porcine model.

The findings demonstrate that rotational guided growth can induce
bone rotation in growing animals but also reveal notable risks that
must be addressed.
The research emphasizes that this technique remains experimental,
requiring further refinement and validation before clinical use.