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PubMed1987

Limb lengthening by epiphyseal distraction. An experimental study in the caprine femur.

Epiphyseal distraction of the left distal femur was accomplished in 10 goats (aged 3-4.5 months). A modified Hoffmann external fixation device was used as a unilateral distraction frame. A distraction rate of 1.5 mm/day was applied for 5.5 weeks. Epiphysiolysis occurred after 3-7 days of distraction. After the lengthening procedure, the growth plate had reduced in height in eight animals on radiographic examination. In two animals the growth plate was fused. Three animals were killed at 4 (Group 1) and 8 (Group 2) weeks and four animals at 16 (Group 3) weeks after the end of the distraction period. The gain in leg length obtained by distraction was reduced owing to growth retardation in the distal femur of the operated limb. The average final lengthening was 24.9, 19.4, and 13.4% in Groups 1, 2, and 3, respectively. Femur and tibia from both sides were tested mechanically in torsion. Only one femur fractured in the elongation area. All but one elongated femur fractured in the area of the diaphysis subjected to distractional force. The torsional strength of the elongated femur compared with control was reduced to approximately 50% in all groups. The corresponding torsional strength of the tibia on the elongated extremity compared with control was reduced to approximately 75% in all groups. The difference in relative strength of femur compared with that of tibia was statistically significant. This finding can be explained by a stress-protective effect on the femur in the distraction area caused by the external device.

Animals↗
PubMed1984

Epiphyseal fractures in children treated for osteosarcoma of the femur with chemotherapy, tumourresection, and endoprosthesis: report of four fractures in two children.

This paper reports on two patients, who both were under treatment for osteosarcoma of the femur. Treatment consisted of chemotherapy, resection of the tumour, and reconstruction with an endoprosthesis . Both patients sustained an epiphyseal fracture on two occasions after a minor trauma. Careful observations of the x-rays, including tomography, reveals that a metaphyseal anomaly could be the cause of these fractures. It is suggested that these metaphyseal changes are caused by chemotherapeutic agents. All fractures healed well after a conservative treatment.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1987

Postradiation slipped capital femoral epiphyses (SCFE).

This study details the case reports of two children who developed slipped capital femoral epiphyses (SCFE) after receiving external irradiation. The clinical and diagnostic features of postradiation SCFE are reviewed and discussed. Guidelines for the management of children who receive pelvic irradiation are presented.

Child↗
PubMed2005

Epiphyseal transplant: harvesting technique of the proximal fibula based on the anterior tibial artery.

Epiphyseal transplants in children were introduced into clinical practice about 20 years ago. Among possible donor sites, the proximal fibula is definitely the most popular choice, and has been used mainly for reconstruction of the proximal humerus and distal radius. Provided that an adequate blood supply both to the physis and to the diaphysis must be restored in order to obtain acceptable axial growth of the transferred fibula and a bone fusion at the osteotomy site, the choice of feeding pedicle is still a controversial issue. Our contribution involves a homogeneous series of 24 patients under 11 years of age who had skeletal reconstruction in the upper limb by means of a vascularized transfer of the proximal fibula based on the anterior tibial artery. The aim of the present paper is to describe in detail the harvesting technique which has been partially modified and gradually refined in our 10-year experience.

Bone Transplantation↗
PubMed1999

Tissue transglutaminase expression in quail epiphyseal chondrocytes.

Tissue transglutaminase (tTGase) is a GTP-binding Ca(2+)-dependent enzyme which catalyses the post-translational modification via epsilon(gamma-glutamyl)lysine bridges. The physiological role of tTGase is not fully understood. It has been shown that in cartilage the expression of tTGase correlates with terminal differentiation of chondrocytes. Recent evidence suggests that the GTP-binding activity of tTGase may play a role in the control of cell cycle progression thus explaining some of the suggested roles for the enzyme.tTGase activity is present in primary cultures of epiphyseal chondrocytes and increases transiently upon retinoic acid (RA) treatment. Increase in enzyme activity occurs upon RA addition and is accompanied by a parallel increase in protein and mRNA levels. Stimulation of tTGase expression by RA correlates with suppression of cell growth and occurs independently of cell adhesion and cell differentiation.tTGase expression is not observed in MC2, a permanent chondrocyte cell line derived from retrovirus infected chondrocytes. RA treatment fails to activate tTGase expression in MC2 cells and to completely suppress cell proliferation. Our findings lend support to the idea that tTGase might play a role in non-dividing cultured chondrocytes.

Animals↗
PubMed1993

Epiphyseal stapling for leg equalization in developing countries.

Epiphyseal stapling to arrest growth in the longer limb in growing children has been used in 923 cases over 26 years in the management of leg length inequality. Five hundred and three were assessed at the end of growth. Seventy-one percent had 0.5 cm to 1 cm of shortening and 80% did not need an orthosis. Although other methods are available, this technique is particularly valuable in developing countries because it needs only basic surgical facilities and the financial cost is low.

Adolescent↗
PubMed1981

Electron-microscopic microprobe analysis on the initial stages of mineral formation in the epiphyseal growth plate.

Dry thin sections (300-500 nm thick) of shock-frozen, freeze-dried and embedded epiphyseal growth plates from the proximal tibia of guinea pigs were cut longitudinally from the plate. Dark round bodies (phi less than 0.5 micron) were observed using the scanning transmission mode of the electron microscope initially directly in the vicinity of the chondrocytes. They gradually spread out in the direction of the metaphysis to the center of the longitudinal septum and represent most probably the matrix vesicles. By use of a microscan of 0.25 X 0.25 micron the element-concentrations of these bodies were measured. The measurements started on those bodies that could be clearly recognized and were extended to a length of 30-40 micron in the metaphyseal direction. To obtain approximate quantitative results the registered CaK alpha and PK alpha x-ray counts were directly compared with counts of fully mineralized regions, the Ca and P contents of which are known. Ca as well as p could be detected in the first visible vesicle-like structures (Ca approximately 0.2%, P approximately 0.4%) and increased steeply in the metaphyseal direction, amounting to approximately 6% Ca and 3% P. These results may lead to the conclusion that Pi becomes split from phosphate esters and transformed into the matrix vesicles already in a very early stage of enrichment. Incorporation of Ca may be coupled with this process.

Animals↗
PubMed1976

Transmission microscopy of freeze dried, unstained epiphyseal cartilage of the guinea pig.

The question of the initial mineralization in the epiphyseal plate has been investigated to date in specimens prepared by conventional electron microscopical techniques. As conventional techniques can produce artifacts, either a loss of mineral substance or a secondary nucleation, the mineralization process was investigated using freeze dried, vacuum embedded growth cartilage which was neither contrasted not stained and which had a very short contact with water. The prevailing theory that the first mineralization begins within extracellular matrix vesicles and that the mineralization outside these vesicles is a secondary process was confirmed. Mineralized matrix vesicles were found in the fully mineralized long septa down to the opening zone. In several cases a mineralization could be observed in those transverse septa in which organic substance was present between the cells. The typical radial arrangement of the apatitic needles and platelets in the matrix vesicles could be explained by the formation of a mineralization in an ionotropic gel, the orientation of the matrix macromolecules to be produced by a vectorial influx of calcium ions and phosphate groups coming from different directions. Thin strands of mineral substance with low contrast, which follow the direction of the longitudinal septum, were assumed to be the mineralized collagen fibrils. In several needles dot-like formations were seen and the distance between the middle of neighbouring dots was found to lie mainly in the range 30-56 A, while the lateral separation distance between the middle of closely packed parallel chains and needles was found to lie mainly in the range 30-42 A. Parallel periodic structures which could be visualized in apatitic chains and needles 20-40 A in diameter were assumed to be the 8.2 A-(100)-lattice planes of apatite, being an indication that these formations already possess criteria of the apatite lattice.

Animals↗
PubMed1980

Perthes' disease--a classification based on the extent of epiphyseal and metaphyseal involvement.

A tentative classification of Perthes' disease according to the extent of epiphyseal and metaphyseal involvement in lateral radiographs of the hip was applied to 61 hips in 55 patients. Forty-four hips were treated by containment (Tachjian's trilateral socket hip abduction orthosis) and 17 hips were treated surgically either by intertrochanteric or sub-trochanteric osteotomy. The results correlated well with the classification of the authors. The greater the extent of involvement of the epiphysis and metaphysis, the severer the resulting deformity. The choice of method of treatment is also discussed. It is concluded that this classification may be of prognostic value and may be useful to differentiate atypical cases.

Child↗
PubMed1980

Epiphyseal clefts.

Defects or clefts may be seen in the growing epiphysis and are usually observed just before puberty. The basal epiphysis of the proximal phalanx of the great toe is the most common site but similar defects have been observed in a number of other epiphyses. At least some of these defects develop within a single normal appearing epiphysis and are not associated with signs or symptoms suggestive of fracture. The mechanism of formation of these defects is not clear. The defects probably close spontaneously sometime around late puberty.

Epiphyses↗
PubMed1980

The epiphyseal spur.

A small spur seen at the edge of an open epiphyseal line indicates the presence of an open epiphysis when this is not clear radiographically. In addition, the spur should not be mistaken for an avulsion fracture.

Adolescent↗
PubMed1994

Immunohistochemical analysis of EGF in epiphyseal growth plate from normal, hypophysectomized, and growth hormone-treated hypophysectomized rats.

Epiphyseal growth plate cartilages from the proximal tibia of normal, hypophysectomized, and growth hormone (GH)-treated hypophysectomized rats were subjected to immunohistochemistry for detection of epidermal growth factor (EGF). In the normal growth plate, EGF was distributed mainly in the proliferative zone. Hypophysectomy resulted in considerable atrophy of the chondrocytes and the cartilage matrix (a decreased number of mature-type chondrocytes and a decreased ratio of proliferating to hypertrophic chondrocytes) and a significant diminution of EGF immunoreactivity. Treatment with GH reversed these effects of hypophysectomy, causing an increased thickness of the growth plate and EGF-reactive sites in all chondrocyte layers. The most intense immunostaining for EGF, however, was frequently seen in the nuclei of chondrocytes with flattened appearance. It appears that EGF could be incorporated or synthesized in chondrocytes having marked mitogenic activity. The present results, taken with previous data on EGF involvement in growth of cartilaginous tissue in vivo and in vitro, strongly suggest that EGF-immunoreactive chondrocytes are involved in cartilage proliferation and growth under the specific influence of GH.

Animals↗
PubMed1988

Ultrastructural demonstration of lectin binding sites in the Golgi apparatus of rat epiphyseal chondrocytes.

Binding sites for wheat germ agglutinin (WGA), Dolichos biflorus agglutinin (DBA), Ricinus communis I agglutinin (RCA I) and Limax flavus agglutinin (LFA) have been ultrastructurally detected in rat epiphyseal chondrocytes by a post-embedding cytochemical technique using colloidal gold as marker. The four lectins labelled exclusively the Golgi apparatus of chondrocytes embedded in Lowicryl K4M resin by two different methods. WGA binding sites were localized in medial and trans cisternae as well as in immature secretory vesicles, whereas those for DBA were seen concentrated in cis and medial cisternae. Labelling with both RCA I and LFA lectins was distributed throughout all the cisternae of the Golgi stack, and the latter also in vesicles and tubules at the trans face. Neuraminidase pretreatment of the sections abolished LFA staining, decreased reaction with WGA and increased that with RCA I, while it did not affect DBA staining. After chondroitinase ABC treatment only the RCA I reaction was modified, revealing new binding sites in the trans Golgi face, secretory granules and extracellular matrix. These results indicate that the distribution of subcompartments in the Golgi apparatus of chondrocytes is different from that in cells secreting glycoproteins as major products.

Animals↗
PubMed1982

Morphological studies on the epiphyseal growth plate combined with biochemical and X-ray microprobe analyses.

The epiphyseal growth plate of the domestic pig was investigated topologically combining biochemical methods with electron microprobe microanalyses both correlated to histological controls. A lateral resolution of about 50 micrometer was reached. Highest nuclease activity was found in the lower columnar cell zone, while alkaline phosphatase showed maximal activity in the hypertrophic area, connected with maximal values for extractable, organically bound phosphorus, and extractable Ca and Mg. Acid phosphatase activity reached maximal values in the zone of the lower primary spongiosa, while the extractable Pi had maximal values at the end of the zone of bone remodelling. Microprobe analyses have shown that the extracellular Ca content (per dry mass) remained relatively constant at 0.7% (about 58 mM/kg wet weight for 66% tissue fluid) in all zones of the plate increasing to 1% in the vicinity of the first foci of mineralization. The intracellular P content (per dry mass) was about 4.5 %, the extracellular 0.1-0.2% (about 10-20 mM/kg wet weight) increasing also to about 1% in the vicinity of the first foci of mineralization. Thus the Ca X P product was much higher than the ion-product of 2 mM2 which is necessary for an in vitro mineralization of connective tissue. The extracellular S content (per dry mass) as a probable indicator of sulfated proteoglycans was relatively constant at about 3.5% in the different zones but decreased to about 0.3% in the fully mineralized regions. This indicates a loss of sulfur containing substances with mineralization which is not so high since the concentrations per dry mass must be normalized to a unit volume of equal density of mass.

Alkaline Phosphatase↗
PubMed1994

Punctate epiphyses: a radiological sign not a disease.

Punctate epiphyses are caused by a diverse group of conditions. They may be an inherited part of certain bone dysplasias or an incidental finding occurring occasionally in various disorders. The pattern of the puncta together with other radiologic findings aid in making the correct diagnosis.

Child↗
PubMed1986

Flattening of the distal femoral epiphyses in the trichorhinophalangeal syndrome.

A new finding in the trichorhinophalangeal syndrome, flattening of the distal femoral epiphyses, is described in seven patients. Measurement of the ratio of the height of the distal femoral epiphysis versus both the width of the distal femoral metaphysis and the width of the distal femoral epiphysis and comparison to normal standards confirmed the subjectively observed flattening of the distal femoral epiphysis in these patients, further suggesting that the disease is a generalized process rather than a local disorder.

Child↗