[Pyle's disease (metaphyseal dysplasia)].
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Fractures with moderate displacement in childhood are usually thought to be benign if they are not epiphyseal. Six cases of fractures of the upper tibial metaphysis in childhood with slight or moderate displacement are reported. In 5 cases progressive genu valgum appeared. On 3 occasions osteotomy was necessary to correct the deformity. The possible causes of such complications are discussed.
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The author has described in 1973 a new approach to the upper end of the humerus. This has been used in 44 cases up to the present time. It is concluded that it is worthwhile in the treatment of tumours, infections, complex fractures or dislocations. However, it should only be used in young adults. In elderly patients, several instances of stiff shoulder have been seen after this approach.
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Fractures of the proximal metaphysis of the tibia in children, not involving the growth cartilage and even if there is no significant displacement between the fragments, may give rise to post-traumatic valgus deformity of the knee. This deformity generally tends to be self-correcting if less than 15 degrees but if it is beyond this it does not have the same tendency to spontaneous correction. In such circumstances the normal alignment should be re-established by osteotomy and epiphysiodesis.
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Selective perfusion and microangiographic examination of the radius and metacarpus of 30 foals were performed. Vessels of extraosseous origin supplying the peripheral part of the metaphysis were not demonstrated in young foals, but became more obvious in older animals. The development of this vessel system coincided with the reduction of transphyseal vessels from the epiphysis crossing the growth plate.
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