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PubMedDate not supplied

Primary epiphyseal transplants and bone overgrowth in childhood amputations.

Seventeen children aged newborn to 14 years underwent major through-bone amputations or revision at our two institutions. Ten patients (group 1) had primary autogenous epiphyseal transplants taken from the amputated limb and used to cap the open medullary canal of the residual limb. Seven patients (group 2) did not have epiphyseal transplants. Nine of 10 patients in group 1 (90%) had no problems related to bone overgrowth or delay in prosthetic fitting. In group 2, six of seven patients (86%) had clinically symptomatic bony overgrowth of 20 months after the index amputation on the average. Four patients had surgical revisions. Therefore, provided healthy autogenous donor epiphyses are available, we recommend primary epiphyseal transplants to avoid the complications of bone overgrowth in childhood through-bone amputations.

Adolescent↗
PubMed1977

Bone growth in foals and epiphyseal compression.

Limb angulation in foals may be due to defects in epiphyseal growth plates. The present state of knowledge concerning rate of growth in foals and differences in growth of different epiphyseal plates is reviewed and the importance of accurate knowledge of these parameters in treatment of angulation by unilateral retardation of an epiphyseal growth plate is stressed. Retardation of epiphyseal plate growth by compression wiring is described and its advantages in comparison with staplings are suggested. Compression wiring was used in 3 cases in which age, bone width and the degree of angulation were known so that the probable rate of bone growth could be assessed and the necessary unilateral bone increment could be calculated. It is suggested that further measurements of these parameters prior to growth plate retardation would give a more accurate comparison of the benefits of stapling and compression wiring.

Animals↗
PubMed1993

Indirect trauma to the growth plate: results of MR imaging after epiphyseal and metaphyseal injury in rabbits.

Abnormalities of the growth plate secondary to epiphyseal and metaphyseal injury were studied with magnetic resonance (MR) imaging, radiography, and histologic examination in 20 rabbits. Epiphyseal injury resulted in either the formation of a bony bridge across the growth plate or focal curving of the growth plate caused by a decrease in longitudinal growth. Metaphyseal injury resulted in interference with endochondral ossification, thickening of the growth plate, and extension of cartilage into the metaphysis. Serial MR images obtained during the first 6 weeks after injury showed persistence of abnormalities of the growth cartilage after epiphyseal injury, but resolution of abnormalities after metaphyseal injury. Abnormalities of the cartilage were best seen on T2-weighted images. Gadolinium enhancement showed reconstitution of metaphyseal vascularity after metaphyseal injury but did not enable detection of transphyseal vascularity after epiphyseal injury until a bony bridge formed.

Animals↗
PubMed1994

Epiphyseal scar of the femoral head: risk factor of osteonecrosis.

PURPOSE: To find out whether a correlation exists between the presence of epiphyseal scar within the femoral head and osteonecrosis at examination with magnetic resonance (MR) imaging. MATERIALS AND METHODS: A total of 117 femoral heads in 60 patients were examined. Lipogenic factors (defined as either the use of steroid or alcohol abuse) were positive in 46 patients (average age, 37 years) and absent in 14 (average age, 47 years). Both hip joints were examined simultaneously at 1.5 T; three pulse sequences were used in each imaging study. All images were interpreted for type of epiphyseal scar and presence or absence of osteonecrosis. RESULTS: Six types of epiphyseal scar (A-F), each with a different shape, were seen. A total of 72 femoral heads had type A or B sealed-off scars; 32 of these 72 had osteonecrosis. Of the 45 femoral heads with type C, D, E, or F perforated scars, only one had osteonecrosis. The difference between these two groups was statistically significant (P < .001). CONCLUSION: The presence of a sealed-off epiphyseal scar was associated with a very high risk of osteonecrosis of the femoral head.

Adrenal Cortex Hormones↗
PubMed1979

Supernumerary epiphyses in the macaque (Macaca nemestrina).

The frequency, age distribution and development of supernumerary epiphyses in the hand and foot were radiographically documented in 98 macaque fetuses and infants. Extra epiphyses were observed only on distal metacarpal 1 and metatarsal 1, and were present in 15% of a cross-sectional sample and 20% of a longitudinal sample. They appeared coincidentally with the ossification of other secondary epiphyses of the hand and foot. Development of extra epiphyses in this species seems to be a normal phenomenon.

Animals↗
PubMed1975

Growth and mitotic rate of the proximal tibial epiphyseal plate in hypophysectomized rats given estradiol and human growth hormone.

Hypophysectomized female immature albino rats were injected with HGH, HGH and estradiol, or estradiol solely. Some animals were left as controls. All animals were killed on day 3 or 5 of the experiment. One hour before sacrifice, the animals were flash labelled with tritiated thymidine. The following parameters were registered: labelling index, thickness of the growth plate, weight gain, and size of the uterus. The following conclusions were drawn. 1. Estradiol decreases the mitotic rate and retards growth of the epiphyseal cartilage. Its effect on the mitotic rate is more pronounced than its effect on the thickness of the tibial epiphyseal plate. 2. HGH increases the mitotic rate and promotes growth of the epiphyseal cartilage. Its effect on the thickness of the epiphyseal plate is more pronounced than its effect on the mitotic rate. 3. Estradiol decreases the mitotic rate even in the presence of HGH. 4. Estradiol seems to have a direct effect on mitosis of the chondrocytes.

Animals↗
PubMed2002

Correcting and lengthening of metatarsal deformity with circular fixator by distraction osteotomy: a case of longitudinal epiphyseal bracket.

The condition known as longitudinal epiphyseal bracket or delta phalanx is a rare congenital anomaly that affects the tubular bones of hand or foot. Metatarsal epiphyseal bracket restrains longitudinal growth, causing progressive deformity and resulting in a short, broad metatarsal and a medially deviated metatarsophalangeal joint and hallux magnus. Although there are some case series describing metatarsal lengthening with the unilateral fixator in the literature, we could not find any case that combines both metatarsal lengthening and deformity correction with the circular external fixator. Gradual lengthening and deformity correction without bone grafting and soft-tissue modification were carried out in a case with bilateral longitudinal epiphyseal bracket of the first metatarsals of the foot. A literature review and treatment method for epiphyseal bracket in a 9-year-old boy is presented. Excellent clinical, and functional results were obtained with circular and semicircular fixators.

Child↗
PubMed1984

Androgen metabolism by human fetal epiphyseal cartilage and its chondrocytes in primary culture.

Androgen metabolism by human epiphyseal cartilage and chondrocytes in primary culture was studied during fetal life. Testosterone (T) and androstendione (delta 4) were incubated with epiphyseal cartilage and with chondrocytes in Dulbecco's medium for 4, 12, and 24 h. Androstanedione, delta 4, dihydrotestosterone (DHT), and androstanediol were separated by bidimensional thin layer chromatography and delta 4, DHT, and T recrystallized in five different solvent systems. The results showed that delta 4 was transformed into androstanedione, DHT, and T whereas T was metabolized into delta 4 and 5 alpha-reduced androgens. In both systems (epiphyseal cartilage and chondrocytes) delta 4 was the principal metabolite produced from T. There were no major differences in the metabolic patterns of delta 4 and T between epiphyseal cartilage and chondrocytes according to sex nor gestational age (11-32 weeks). In conclusion, 5 alpha-reductase activity was found in chondrocytes from human fetuses of both sexes, but T was mainly transformed into delta 4.

Androgens↗
PubMed1997

Normal gadolinium-enhanced MR images of the developing appendicular skeleton: Part 2. Epiphyseal and metaphyseal marrow.

OBJECTIVE: We have studied how gadolinium enhancement of T1-weighted MR images affects the expected normal differences in signal intensity between metaphyseal hematopoietic and epiphyseal fatty marrow. We have also analyzed how enhancement affects the expected normal changes in the MR images of the marrow due to fatty conversion. MATERIALS AND METHODS: We analyzed gadolinium-enhanced MR images of normal distal femurs in 18 immature rabbits that were 5-11 weeks old and of normal proximal femurs in 18 infants, children, and young adults who were 2 months to 21 years old. In all subjects, we studied the change with age in signal intensity and enhancement ratio of the epiphyseal and metaphyseal marrow. In the rabbits, marrow composition and transformation were histologically verified. RESULTS: On unenhanced T1-weighted MR images of the rabbits and of the infants, children, and young adults, epiphyseal signal intensity always exceeded metaphyseal signal intensity; however, the enhancement ratio was always greater in the metaphysis. The signal intensity in metaphyseal and epiphyseal marrow on unenhanced MR images increased with age. However, enhancement ratios decreased with age in both areas. In the rabbits, histologic studies showed more fatty marrow in the epiphysis than in the corresponding metaphysis and an age-related increase in marrow fat at both sites. CONCLUSION: In the marrow of the extremities, gadolinium enhancement is greater in the (hematopoietic) metaphysis than in the (fatty) epiphysis. In both areas, enhancement decreases as the marrow becomes more fatty. On T1-weighted images, administration of a gadolinium-containing contrast agent reduces the normal contrast between hematopoietic and fatty marrow and obscures the changes in marrow signal intensity due to fatty conversion.

Adolescent↗
PubMed1979

Remodelling after distal forearm fractures in children. II. The final orientation of the distal and proximal epiphyseal plates of the radius.

In 39 children the steric orientation of both the distal and the proximal epiphyseal plates of the radius was evaluated 4 months to 10 years after distal forearm fractures that had healed with residual angulation. A residual fracture angulation was found to induce a change in orientation of both the distal and proximal epiphyseal plates. The final result of the reorientation was a normalization of the inclination of the plates in relation to the long axis of the bone. The proximal epiphyseal plate attained practically a normal orientation. The distal epephyseal plate tended towards overcorrection. In two of the four cases with a primary angulation exceeding 20 degrees considerable normalization occurred, but a "normal" state was not reached. This indicates an upper limit for angulations permitting normalization of the orientation of the distal epiphyseal plate of the radius.

Adolescent↗
PubMed1989

Necrosis of the femoral head in growing rats. Occlusion of lateral epiphyseal vessels.

The cause of the vascular occlusion in necrosis of the femoral head of growing, spontaneously hypertensive rats was investigated histologically using serial sections. The lateral epiphyseal vessels, which supply the proximal femoral epiphysis, disappeared immediately before entry into the femoral heads. In fresh osteonecrosis the pathway of the vessels between the margin of the articular cartilage and the growth plate was replaced with granulation or scar tissue. We conclude that the vascular occlusion occurs in the layer of the epiphyseal cartilage where the lateral epiphyseal vessels penetrate, and that the abnormalities of the epiphyseal cartilage might play a part in the occurrence of osteonecrosis.

Animals↗
PubMed1976

Manganese levels and the morphology of the epiphyseal plate in broilers with slipped tendons.

Manganese deficiency in chickens results in perosis and a higher incidence of slipped tendon. Perosis is associated with a disorganization of the epiphyseal growth plates and changes in the chemical composition of the cartilage matrix. Male broilers with slipped tendons were selected from a commercial broiler farm over a 9 week growing period. Their growth rates, epiphyseal cartilage histology and tissue manganese concentrations were examined and compared with (a) normal broilers from the same farm, and (b) similar broilers raised on control and manganese deficient diets. Field broilers with slipped tendons showed no evidence of abnormality in the histological appearance of the proximal tibial growth plate at any of the ages examined. The manganese content of liver and epiphyseal cartilage from field broilers showing slipped tendon was comparable with that present in tissue from normal broilers wither from the field or raised on a chemically defined diey supplemented with managese. The slightly retared growth rate seen in the field broilers was attributed to feeding problems associated with the lameness condition. These results provide conclusive evidence that slipped tendon in field broilers is not dur to a manganese deficiency in the tissues, nor does it appear to be associated with abnormal proliferation of the chondrocytes in the epiphyseal plate.

Animals↗
PubMed1989

[The biomechanical significance of the periosteum for the epiphyseal groove].

In a study of 72 rabbits, four, eight, twelve and 16 weeks old, the mechanical resistance of the distal radius and ulna epiphyseal plate against shear strength has been examined. On one side the extremity has been freed of all soft-tissue attachments except the periosteum, on the other side the periosteum of the epiphyseal plate additional has been removed. The mechanical strength of the epiphyseal cartilage increases with age. A decrease of the resistance during sexual maturation has not been observed. In all age groups the stability of the epi-metaphyseal junction is significantly higher with the periosteum. In younger animals it is more marked than in older ones. The biomechanical behaviour of the periosteum can be explained with the principle of a "traction strap": the fibrous periosteum, firmly attached at the perichondrial ring, is stretched from epiphysis to epiphysis and fixes the epiphysis to the metaphysis. The periosteum and its continous tension takes not only part in regulating the longitudinal growth but also increases the resistance of the growth cartilage against shear strength. The dominated influence of the periosteum on the integrity of the epiphyseal cartilage is also supported by corresponding results dealing with the occurrence of Salter and Harris-type I or II fractures in absence or presence of the periosteum.

Age Factors↗
PubMed1979

Growth behaviour of condylar cartilage and epiphyseal cartilage on the different medium of the organ culture.

In order to compare histological differences between the condylar and epiphyseal cartilages, an organ culture system was employed. Materials from 36 neonatal rabbits were cultured for 7 days on three different, chemically defined media (Ham F12, Medium 199, and Eagle's minimum essential medium) with the addition of various concentrations of ascorbic acid, fetal calf serum and NaHCO3. The epiphyseal cartilage was maintained in situ histological and biochemical features better than the condylar cartilage on any of the medium used. The maximum sensitivity to Toluidine Blue staining of the cultured condylar cartilage was observed on Ham F12. For both the condylar and epiphyseal cartilages, Ham F12 with the addition of 50 microgram/ml ascorbic acid and higher concentration of NaHCO3 was more effective on the maintenance of cell organization. However, effect of the addition of fetal calf serum to the medium was quite different between the condylar and epiphyseal cartilages, that is, the former showed better histological features without the addition, but the latter showed features similar to that in situ with 20% addition of fetal calf serum.

Animals↗
PubMed1979

[The epiphyseal defect in children (author's transl)].

The authors produced four cases which all show at first almost the same radiographical espect: an epiphysal defect of the knee. The first case developed in an inflammatory context and proved to be an osteomyelitis. The second case showed a begnin tumour on X-Ray examination a chondroblastoma. Then an epiphysal tuberculosis was produced which at first led to a rather unsettled diagnosis. The last case was a rare observation of chondrome. The diagnostic problems are frequent and besides possible infections localisations, the diagnosis of chondrablastome seems to be the most likely. Surgical approach of such epiphysal lesions is justified not only to corroborate etiology but also in order to avoid an increase in the volume that could impair the epiphysal plate endanger the growth.

Bone Neoplasms↗
PubMed1980

[Treatment of injuries to the epiphyseal synchondrosis (author's transl)].

Treatment of epiphyseal injuries must take the pathophysiology of the epiphyseal synchondrosis into account. According to the present state of knowledge, type I and type V injuries according to Müller can be stabilized sufficiently by means of a plaster cast. All other types of epiphyseal injuries should be subjected to very accurate repositioning and stabilised in "waterproof" condition by means of osteosynthesis to avoid growth disturbance caused by periosteal interposition or callus bridge formation. Hence, surgical treatment is recommended for type II according to Müller as well. In some cases, epiphyseal synchondrosis may close even if greatest care had been exercised during surgery. In all probability, this would be attributable to crush syndrome.

Bone Nails↗
PubMed1984

Fractures and epiphyseal deformities in beta-thalassemia.

Sixty-two patients with beta-thalassemia (36 men and 26 women) were investigated in a survey of the incidence and distribution of fractures. Patient ages ranged from 10 to 32 years (mean, 16.7). The examination consisted of a detailed orthopedic and roentgenographic skeletal survey. Fractures are a frequent occurrence in beta-thalassemia (Cooley's anemia). One in three patients had sustained fractures. In one of five, fractures were multiple or recurrent. The fractures, however, were not entirely responsible for the high incidence of deformities. Only one patient had a malunited limb-deforming fracture. The high incidence of deformities was caused by the premature fusion of the epiphyses of the long bones; the pathogenesis of beta-thalassemia-induced epiphyseal fusion is obscure. Thirty patients of the 62 patients developed epiphyseal abnormalities, generally in the lower tibial and fibular, upper humeral, and lower femoral epiphyses. The ensuring deformities are severe and frequently occur in patients older than 12.

Adolescent↗
PubMed1982

[Epiphyseal fractures and epiphysiolyses of the distal tibia].

In the years 1979, 1980 and 1981 a follow-up of 72 epiphyseal of the distal tibia was made. Half of the cases of epiphyseal fractures were treated conservatively, the other half operatively. Epiphysiolyses were treated conservatively without exception. In both groups disturbances of growth with partial closure of the growth plate and following malgrowth were found. The statistic evaluation of the case histories showed neither a sign of the cause nor a definite primary therapeutic influence on the disturbance of growth. On the basis of these results the classification effected to date of the epiphyseal traumas as well as their prognosis will be critically examined. From the clinicotherapeutic point of view epiphyseal fractures must be classified as joint lesions and epiphysiolyses as shaft fractures, even if the later are still lesions of the growth plate if considered from an anatomical point of view. On the basis of a clinically-orientated new classification of growth plate lesions, therapeutic principles are discussed.

Adolescent↗