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At least 649 records · Page 36Linked to original sources
PubMed2005

Usefulness of epiphyseal quotient measurement on magnetic resonance images for outcome prediction in patients with early-stage Legg-Calve-Perthes disease.

To investigate the usefulness of epiphyseal quotient (EQ) measurement for outcome prediction in patients with Legg-Calve-Perthes disease (LCPD), magnetic resonance (MR) imaging was performed in 26 patients with unilateral LCPD within 6 months of the disease onset and subsequently once every 3 months. All the patients were treated conservatively in our institute between 1990 and 1999. The mean follow-up period was 80 months. Clinical outcome was evaluated based on the plain radiograms of the femoral head at the final examination according to Stulberg's classification: the patients whose outcome was class I were regarded as 'excellent' (excellent group), class II as 'good' (good group), and classes III, IV and V as 'poor' (poor group). The excellent group consisted of 10 patients, the good group of 12, and the poor group of four. The EQ measured on MR images (MR-EQ) decreased remarkably in the poor group chronologically, whereas there was no decrease in the excellent group and a slow decrease in the good group. The mean MR-EQ at or before the sixth month (range, 2-6 months; mean, 4.9 months) was 86.2 (range, 76.8-94.8) in the excellent group, 78.3 (57.0-93.4) in the good group, and 67.4 (57.8-74.5) in the poor group (P<0.05 among the three groups). According to our results, because all patients having an MR-EQ at or before the sixth month of 75 or higher were classified in the excellent or good groups, it is thought that the ongoing method of treatment can be continued. On the other hand, since half of the patients having an MR-EQ at or before the sixth month of lower than 75 were classified in the poor group and had a high potential for a poor outcome, it is thought that these patients require strict containment therapy, and altering the surgical procedure could be considered depending on the particular patient. It was thought that the MR-EQ is a useful predictive factor of LCPD prognosis.

Child↗
PubMed1983

Adolescent traumatic dislocations of the shoulder with open epiphyses.

Nine of 212 cases of traumatic anterior shoulder dislocations occurred in children with clearly open epiphyses (4.7% incidence). All cases associated with psychological or physical abnormalities were excluded. A high recurrence rate of 80% (8 of 10) was noted requiring operative intervention. Two of the three remaining unoperated cases had a history of "subluxation" after their initial dislocation.

Adolescent↗
PubMed1983

Bilateral failure of the capital femoral epiphysis: bilateral Perthes disease, multiple epiphyseal dysplasia, pseudoachondroplasia, and spondyloepiphyseal dysplasia congenita and tarda.

A radiographic survey of 25 patients with bilateral Perthes disease is compared with four inherited skeletal dysplasias also affecting the hip joints (45 patients with multiple epiphyseal dysplasia, 22 with spondyloepiphyseal dysplasia tarda, 18 with pseudoachondroplasia, and 17 with spondyloepiphyseal dysplasia congenita). The distinguishing features in relation to the pelvis and hip joint in the growing child are ascertained, in view of the importance of differentiating as early as possible the transient disorder of Perthes disease from the more serious progressive disorders.

Acetabulum↗
PubMedDate not supplied

Postnatal epiphyseal development: the distal tibia and fibula.

At birth, the distal tibial physis is a transverse structure. However, as the tibia enlarges diametrically and the epiphyseal ossification center matures, the physis becomes increasingly undulated, with peripheral lappet formation. The anteromedial area is the first to develop undulation (Poland's hump). This should not be misinterpreted as an injury or premature epiphyseodesis subsequent to trauma. The tibial secondary ossification center forms within the central epiphysis. The medial margin is irregular and may have peripheral foci of ossification. Between the ages of 7 and 8 years, this secondary center extends into the medial malleolus, reaching the distal tip during adolescence. The malleolar tip may develop accessory ossification. Physiologic epiphyseodesis begins over the medial malleolus and then extends laterally, a pattern of closure that affects fracture patterns (e.g., the fracture of Tillaux). The distal fibular physis also begins as a transverse structure that becomes undulated and has extensive peripheral lappet formation. This physis usually becomes level with the articular surface of the distal tibia after the first year. Enchondromalike extensions of the physis into the metaphysis are common. Accessory ossification may develop at the distal end.

Adolescent↗
PubMedDate not supplied

Metatarsal epiphyseal bracket: treatment by central physiolysis.

Longitudinal epiphyseal bracket (LEB) is a rare ossification anomaly in which an epiphysis brackets the diaphysis of a phalanx, metacarpal, or metatarsal. This abnormal epiphysis tethers longitudinal growth, resulting in a shortened and oval-shaped bone. Four patients with five LEBs were treated by central physiolysis and followed for a mean of 6 years. The patients had significant hallux varus deformity. Three patients had duplicated great toes, and two had tibia hemimelia significant enough to require epiphysiodesis as they neared adolescence. Resection of the LEB allowed the proximal and distal epiphysis to resume untethered growth. Silastic or methyl methacrylate was placed over the resected physis to prevent bony rebridging. The associated hallux varus deformity was corrected by capsulorrhaphy and K-wire fixation. In all patients, the metatarsal resumed longitudinal growth and correction of the hallux varus was maintained.

Child↗
PubMedDate not supplied

Fractures of the distal femoral epiphyseal plate.

A retrospective analysis of 30 consecutive fractures of the distal femoral epiphyseal plate showed the best results occurred when fractures were anatomically reduced and fixed with pins. No fractures with internal fixation displaced, whereas 43% of fractures reduced without fixation displaced during cast treatment. Complications were more frequent in displaced than nondisplaced fractures. We were unable to demonstrate that gentle reduction under general anesthesia offered protection against subsequent physeal arrest when compared with closed reduction in the emergency room; however, reductions in the operating room were more likely to be anatomic.

Adolescent↗
PubMedDate not supplied

Epiphyseal replacement in a murine model.

Epiphyseal replacement was performed via knee transplantation using donor tissue of different developmental times in a murine model. The performance of syngeneic donor tissue in a resection defect in 4-day-old mice of the same inbred strain was assessed over 2 weeks for cell viability, tritiated thymidine incorporation, and ability to attract a host blood supply, and at 2 months, with the existence of a joint and growth. Although there was variability within experimental groups, the syngeneic transplant was able to survive pending vascular invasion from the host. Growth occurred, although it never equaled normal growth. One possible approach to the difficult problem of joint reconstruction in the immature skeleton is to divide the endeavor into two parts: develop models of syngeneic joint transplantation in inbred strains of animals to assess the various problems that would occur were this tissue available and develop models of joint "synthesis" with autogeneic chondrocytes.

Animals↗
PubMed1975

Syndrome of epiphyseal dysplasia, short stature, microcephaly and nystagmus.

This report describes two brothers with short stature, congenital nystagmus and microcephaly. The radiographic findings disclosed small, irregularly shaped epiphyses, square iliac bones and flattened acetabulae. The humeri and femora were short. The parents were normal. The syndrome is possibly X-linked, or autosomal recessive in origin.

Bone Diseases, Developmental↗
PubMed1998

Fracture epiphyseal separation of the distal humerus.

Seven patients seen with fracture separation of the distal humerus epiphysis have been analysed for the problems linked with the radiological diagnosis of this injury. Peculiar male predominance, exclusive left-side involvement, consistent postero-medial displacement of the epiphyseal fragment and ability to achieve near anatomic reduction by closed manipulation in fresh cases have been some of the other features observed. The literature has been briefly reviewed for this infrequent and usually misdiagnosed injury.

Child↗
PubMed1995

The role of estrogen in pubertal skeletal physiology: epiphyseal maturation and mineralization of the skeleton.

The year 1994 is likely to be remembered by many endocrinologists as the year in which dramatic new light was shed on the role played by estrogen in human skeletal physiology. It was in 1994 that two new syndromes were described, each representing a human model in which estrogen action was lacking. The first case was a female with an aromatase defect and a resultant inability to synthesize estrogen, and the second case was a man with an estrogen receptor gene defect that resulted in a non-functioning estrogen receptor and complete estrogen resistance. By examining the phenotypes of these two individuals, we were able, for the first time, to see what pubertal skeletal changes occur in the absence of estrogen action and directly extrapolate the role of estrogen in skeletal physiology. What has become abundantly clear is that it is estrogen and not androgen that is responsible for pubertal epiphyseal maturation and skeletal mineralization.

Androgens↗
PubMed1978

Isolated epiphyseal chondrocyte allografts into joint surfaces. An experimental study in rabbits.

Isolated epiphyseal chondrocytes from 5 week old female New Zealand white rabbits were transplanted as allografts into drill holes in the tibial articular surface of adult male New Zealand white rabbits. The grafts were examined after 8 weeks. Fresh chondrocytes which were partially separated from their matrix were more successful (47%) than completely separated cells (20%) and were significantly more successful (P greater than 0.05) in skeletally mature (58%) as opposed to immature recipients (20%). Storage of the cells at -79 degrees C for 2 to 9 days or at -196 degrees C for 36 to 58 weeks gave successful results of 23% and 33%, respectively. Control defects showed fibrocartilage filling the defect in 25%. The factors affecting survival of chondrocyte allografts require further study before clinical application of the method.

Animals↗
PubMed1980

An epiphyseal stress fracture of the foot and shin splints in an anomalous calf muscle in a runner.

The following case is presented as one of unusual foot and leg lesions encountered in an adolescent long-distance runner. The associated problems of a first metatarsal Salter Harris type II epiphyseal stress fracture, and an accessory calf muscle with "shin splints" in the contralateral leg are discussed. Treatment of these conditions is outlined with eventual return to full function by the athlete.

Adolescent↗
PubMed1987

Spastic paraplegia associated with brachydactyly and cone shaped epiphyses.

Male uniovular twins presented at the age of 20 years with spastic paraplegia which had been slowly progressing over the years. Both have skeletal anomalies of their hands and feet with brachydactyly, cone shaped epiphyses, and an abnormal metaphyseal phalangeal pattern profile. In addition, they have a non-specific dysarthria and low-normal intellectual ability.

Adult↗
PubMed1978

Slipped capital femoral epiphyses complicating renal osteodystrophy: a report of three cases.

Three adolescents with bilateral slipped capital femoral epiphyses complicating renal disease are presented. In one case, the severity of the deformities necessitated total hip replacement. Pathological specimens were available for evaluation. In all 3 cases, epiphysiolysis was accompanied by severe subperiosteal reabsorption along the medial aspect of the femoral neck, widening of the cartilaginous growth plate, and coxa vara. The radiographic diagnosis of a minimally displaced femoral epiphysis may precede the clinical symptoms. Early recognition of this complication is important, since the treatment of choice is prophylactic surgical stabilization before disabling deformities occur.

Adolescent↗
PubMed1979

Variability of unilateral epiphyseal dysplasia (dysplasia epiphysealis hemimelica).

Nine cases of dysplasia epiphysealis hemimelica (Trevor disease) are reviewed. This osteocartilaginous process arises from the epiphysis and most commonly involves the ankle and knee. While usually mild, 3 cases of greater severity were found with associated arrest of the growth plate. One mild and 2 severe cases are presented in greater detail. The term unilateral epiphyseal dysplasia is proposed as the condition may involve the upper extremity and often involves more than half the epiphysis.

Ankle↗
PubMed1980

The vanishing epiphyseal ossification center: a sequel to septic arthritis of childhood.

Radiographic disappearance of a previously ossified epiphyseal center may occur during the acute episode of septic arthritis, or during the healing phase after adequate treatment. The fact that the cartilage remains normal suggests that reparative revascularization, rather than enzymatic dissolution of bone and cartilage by the infecting organism, is responsible for the disappearance of the ossification center.

Arthritis, Infectious↗