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Sagittal alignment improved in both groups. Statistically significant PDFA changes were observed in the tension-band plate group (P = 0.0095); a trend was noted toward improvement in ACL angle (P = 0.08). PPTA did not change. No changes reached significance in the transphyseal screw group (PDFA P = 0.181, ACL P = 0.64). Tension-band plate migration was noted in one (7.7%) of 13 knees, and transphyseal screw migration in nine (56.3%) of 16 knees (P less then 0.01). Anterior distal femoral growth modulation improves sagittal alignment wit
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