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PubMed2001

Additional manal and pedal epiphyseal centres.

One hundred and thirty-six well-preserved medieval skeletons were excavated in advance of re-development in Norwich. Examination of sub-adult hand and feet bones indicated a high percentage of accessory epiphyses. The majority could be identified by traces of a fusion line. The distal first metacarpal and first metatarsal being the preferred sites. Such additional epiphyses have rarely been reported in archaeological samples and the findings are in strong contrast to the figures quoted in modern anatomical texts. The possible reasons for this apparent variation are discussed.

Adolescent↗
PubMed1997

A rare case of complete proximal epiphyses (so-called pseudoepiphyses) of the metacarpal and metatarsal bones in the human.

We report a rare case of complete proximal epiphyses (so-called pseudoepiphyses) of metacarpal and metatarsal bones in a human. These phenomena were seen in both the hands and feet of a seven-year-old girl undergoing medical examination for pain in the right foot. During medical treatment, X-ray photographs of the hands and feet were taken. Each metacarpal and metatarsal bone except for the first metacarpal bones had supernumerary epiphyses (complete pseudoepiphyses) at the nonepiphyseal end of these bones. This is a rare case even for an experienced orthopaedic surgeon.

Child↗
PubMed1996

Occurrence of PG-Lb, a leucine-rich small chondroitin/dermatan sulphate proteoglycan in mammalian epiphyseal cartilage: molecular cloning and sequence analysis of the mouse cDNA.

PG-Lb is a chondroitin/dermatan sulphate proteoglycan first isolated from chick embryo limb cartilage. It had been assumed that osteoglycin represents its mammalian homologue. However, partial amino acid sequences of a novel proteoglycan from bovine epiphyseal cartilage showed high identity with those of chick PG-Lb (P. Neame, L. Rosenberg and M. Höök, personal communication). Reverse transcriptase PCR using degenerate oligonucleotide primers gave a cDNA fragment that might correspond to mouse PG-Lb. We isolated a clone from a cDNA library of newborn mouse epiphyseal cartilage using the cDNA fragment as a probe. The cloned cDNA was 1430 bp long and contained a 966 bp open reading frame which encoded the core protein consisting of 322 amino acid residues. The deduced amino acid sequence showed a high overall identity with chick PG-Lb (about 62%, reaching about 80% over the carboxyl two-thirds). In addition, the amino acid sequence contained a signal peptide, six cysteine residues at the invariant relative position to chick PG-Lb, six leucine-rich repeats at the carboxyl two-thirds, three possible glycosaminoglycan-attachment sites (two sites at the N-terminal side and one site at the C-terminus) and two possible Asn-glycosylation sites near the C-terminus. Northernblot analysis demonstrated the specific expression of a 1.5 kb message in cartilage and testis. These structural features and the characteristic expression suggest that the cloned molecule is mouse PG-Lb.

Amino Acid Sequence↗
PubMedDate not supplied

Pediatric longitudinal epiphyseal bracket: Review and case presentation.

The longitudinal epiphyseal bracket is a rare deformity affecting the long and short bones of the hands and feet, creating an aberration in growth. The deformity is present in 2% to 14% of congenital hand and foot deformities, with 11% of all cases found in the great toe. Ultrasound may then be used to confirm the diagnosis. Radiographs usually show the presence of a bracket epiphysis once there is some ossification, but until then, the radiographs can appear normal. With the use of ultrasound, a suspected preossified bracket can be visualized and can establish the diagnosis. The purpose of this article is to present such a case with a preossified epiphyseal bracket of the great toe. The child presented initially with unremarkable x-rays, but the diagnosis was made with clinical suspicion and use of ultrasound. After surgical resection of the brackets, there was progressive improvement in the short-term follow-up. Long-term follow-up is essential until skeletal maturity, and, if the deformity persists, further surgical care may need to be implemented.

Child, Preschool↗
PubMed1994

[Sports-induced epiphyseal injuries of the knee and ankle joint].

We report on the clinical and radiological follow-up results of 37 patients with epiphyseal injuries of the knee and ankle joint who were treated in our hospital between 1985 and 1990. Most of the ankle joint injuries were sustained during track and field, soccer and basketball, and most of the knee injuries during alpine skiing. The different mechanisms of injuries of the knee and ankle joint are discussed on the basis of our own results. The therapy considers the age of patient as well as localisation and type of the epiphyseal injury. In spite of this, growth disturbances occurred in 12.5% of the ankle joint and in 9.5% of the knee joint injuries.

Adolescent↗
PubMed1991

[Epiphyseal injuries of the lower extremity in sports].

Sports-related epiphyseal injuries have been becoming more prevalent during the last years. We are reporting 85 patients with epiphyseal fractures of the lower extremity treated in our hospital during the last twenty years. The injuries were sustained during soccer in 28% and during alpine skiing in 26% of the cases, of which the former was responsible for most of the injuries reported in males and the latter for those in females. The most frequently seen localization was the upper ankle joint (48 cases), followed by the proximal tibial (15 cases) and the distal femoral epiphysis (10). Of the patients, 56% were treated surgically, while conservative treatment was chosen for 44% of the patients. Of the 49 patients available for follow-up complications were documented in 10 cases, including 3 leg length discrepancies, 5 axis deviations, one avascular necrosis of the femoral head and one case of osteomyelitis, of which 6 required operative surgery.

Adolescent↗
PubMedDate not supplied

[Epiphyseal tumors].

The epiphyses of bone have a different physiologic development and pathophysiology compared to the other skeleton. Hereby the very low incidence of primary bone tumors has to be noted. The analysis of our tumor register, including 2758 cases, and of the literature confirms the chondroblastoma as the most frequent bone tumor especially in the second decade of life. Besides this we find chondromas of the epiphysis in infancy. Osteoid osteomas and osteoblastomas as well as tumor-like lesions and osteomyelitis occur extremely rare. We had no case of a primary malignant bone tumor in our register. Moreover less than 10 cases of osteosarcoma of the epiphysis have been reported in the literature. The border between metaphysis and epiphysis can not be distinguished any more after closure of the epiphyseal growth plate so that primary and secondary bone tumors can develop in this region now. An isolated occurrence of tumor in the epiphysis is even rare in adolescence.

Adolescent↗
PubMedDate not supplied

[Fractures and epiphyseal injuries in children with myelomeningocele].

Between February 1971 and February 1988, 947 children with myelomeningocele were treated at the Model Center of Heidelberg University Orthopedic Clinic. In 82 of these children, a total of 224 osseous lesions were seen. Metaphyseal and diaphyseal fractures were far more common than epiphyseal lesions, among which epiphysiolysis dominated. Diagnostically important symptoms included swelling, local hyperthermia, and high temperature. Owing to the paralysis, pain is of no value in diagnosing fractures. Protruding periosteal detachments are a common feature of lesions, and if this special form of healing of such fractures is unknown they may cause problems in differential diagnosis. Fractures in children with spina bifida should be treated conservatively, except for fractures of the femoral neck and epiphyseal lesions, which are treated with transcutaneous Kirschner wiring. Immobilization in plaster, postoperatively and during treatment of the injury, is the most common cause of osseous lesions in spina bifida children. Immobilization in plaster should therefore be minimized.

Adolescent↗
PubMed1969

Vesicles associated with calcification in the matrix of epiphyseal cartilage.

Vesicles have been identified within the cartilage matrix of the upper tibial epiphyseal plate of normal mice. They were seen at all levels within the plate and usually did not appear to be in contact with cartilage cells. Vesicles were concentrated within the matrix of the longitudinal septa from the proliferative zone downward. They varied considerably in size ( approximately 300 A to approximately 1 micro) and in shape. They were bounded by unit membranes, and contained materials of varying density including, rarely, ribosomes. A close association was demonstrated between matrix vesicles and calcification: in the lower hypertrophic and calcifying zones of the epiphysis, vesicles were found in juxtaposition to needle-like structures removed by demineralization with ethylenediaminetetraacetate and identified by electron diffraction as hydroxyapatite and/or fluorapatite crystal structure-the former being indistinguishable from the latter for most cases in which electron diffraction methods are employed. Decalcification also revealed electron-opaque, partially membrane-bounded structures within previously calcified cartilage of the epiphyseal plate and underlying metaphysis which corresponded in size and distribution to matrix vesicles. It is suggested that matrix vesicles are derived from cells and that they may play a role in initiating calcification at the epiphysis.

Animals↗
PubMedDate not supplied

Double type III epiphyseal separation of distal ulna associated with ulnar nerve palsy.

This article presents a previously unreported double type III epiphyseal separation of the ulnar head associated with ulnar nerve palsy. The ulnar epiphysis burst into volar and dorsal segments, the latter giving rise to the ulnar nerve palsy. The patient was treated by open reduction of the translocated epiphysis and neurolysis of the ulnar nerve. Although good clinical results were obtained after surgery, forearm rotation remained limited, confirming that open reduction immediately after injury is mandatory in treating type III epiphyseal separations.

Adolescent↗
PubMed1975

A radiologic sign of lateral subluxation of the distal tibial epiphyses.

Linear calcification of the interosseus membrane at the ankle in a juvenile who has sustained an eversion/abduction injury with otherwise normal radiographs indicates that a Type I injury has occurred to the distal tibial and fibular epiphyses, with displacement at the time of injury. This is a significant injury with the potential to cause growth arrest of the tibial epiphyseal plate.

Ankle↗
PubMed2004

Vertebral forward slippage in immature lumbar spine occurs following epiphyseal separation and its occurrence is unrelated to disc degeneration: is the pediatric spondylolisthesis a physis stress fracture of vertebral body?

STUDY DESIGN: Radiographic and histologic evaluation of a rat model of lumbar spine slippage. OBJECTIVES: To clarify the pathomechanism of slippage in the immature spine. SUMMARY OF BACKGROUND DATA: There are controversial hypotheses regarding the pathogenesis of slippage of the pediatric spine with pars defects. Some studies supported that disc degeneration was its cause, while others indicated the growth plate injury was the cause. METHODS: An immature lumbar spine slippage model in 4-week-old rats was used. Following posterior destabilizing surgery, the lumbar spine was radiographically and histologically examined at 1, 3, 5, and 7 days after surgery. RESULTS: Radiographically, slippage occurred about 7% in the % slip on day 7, and no slippage was observed before day 5. Histologically, epiphyseal separation also appeared on day 7; before day 5, the growth plate showed no abnormalities. Within 7 days after the operation, the anulus fibrosus did not show any sign indicating degeneration. The nucleus pulposus was also normal up to day 7. CONCLUSION: The findings of this study support the hypothesis that vertebral forward slippage of the immature spine occurs following epiphyseal separation and its occurrence is unrelated to disc degeneration.

Animals↗
PubMed1998

'Epiphyseal dysgenesis' in Laurence-Moon-Biedl-Bardet syndrome.

Ten patients with Laurence-Moon-Biedl-Bardet syndrome were investigated. They all belonged to one large family within which several intermarriages had taken place. We found that, apart from the already described abnormalities, these patients suffered from dysgenesis of the following epiphyses: vertebrae, proximal femur, proximal tibia, capitellum, tarsal navicular, and the distal epiphysis of the first metatarsal. The degree of polydactyly, a prominent feature of this syndrome, varied from patient to patient, ranging from a wide fifth metatarsal or metacarpal to a complete sixth digit. As in other epiphyseal dysgenesis, a pseudoepiphysis of the distal first metacarpal was present. One patient (the eldest) was tetraparetic due to severe spinal stenosis.

Adolescent↗
PubMed1984

Slipped capital femoral epiphysis: factors affecting shear forces on the epiphyseal plate.

Very little is known regarding the magnitude of physiological shear forces in the normal capital femoral epiphyseal plate. Changes in these forces related to deformities in the proximal femur have been postulated to increase significantly the shear forces and predispose to slipped epiphysis. By force analysis techniques, a three-dimensional model has been developed to study the change in shear forces that might be expected from abnormal angulation in the frontal and sagittal planes. This study suggests that within the range of normal activity, shear forces on the epiphyseal plate are well below the critical values required to cause a slip. Angular deformities of up to 30 degrees in either the frontal or sagittal planes, by themselves, are unlikely to raise these forces to a critical value.

Body Weight↗
PubMedDate not supplied

Narrow window of bone age in children with slipped capital femoral epiphyses.

Pelvis radiographs of 30 children with slipped capital femoral epiphyses (SCFE) were reviewed by four readers to determine the skeletal age. The average chronologic age for girls was 12.1 +/- 1.0 years and that for boys was 14.4 +/- 1.3 years; the average pelvic bone age was 13.2 +/- 0.6 for girls and 15.1 +/- 0.6 years for boys. The chronologic age range was 98 months, and skeletal age range was only 50 months. Pelvis bone age was advanced in the youngest children, normal in most children, and mildly delayed in older children. We conclude that there is a uniform skeletal age or "narrow window" during which epiphyseal slipping occurs, regardless of the child's chronologic age.

Adolescent↗
PubMed1976

25-hydroxyvitamin D: autoradiographic evidence of sites of action in epiphyseal cartilage and bone.

Tritiated 25-hydroxyvitamin D3 was administered to growing rats to morphologically documents its sites of action. Highly selective incorporation occurred in epiphyseal hypertrophic cells, epiphyseal matrix, osteoid, osteoblasts, and osteocytes of metaphyseal bone spicules. The labeled metabolite appeared in chondrocytic lacunar matrix coincident with hypertrophic cell death as evidenced by histological examination. The tritiated 25-hydroxyvitamin D3 became localized only in areas of active mineralization.

Animals↗