- Discussion:
- bone bridge obliterates
growth-plate cartilage & prevents growth;
- peripheral bone bridges predispose patient to angular deformities;
- Radiology:
- extent of bone bridge is demonstrated by CT scanning and tomograms;
- Indications for Bone Bridge Resection:
- resection is indicated if less than 1/3 to 1/2 of growth plate is involved;
- younger children tend to have a better prognosis w/ resection than older children;
- less than 2 years of remaining growth is a relative contra-indication for bone bridge resection;
- central bars are more amenable to resection than peripheral bars;
- ischemic or septic related bone bars have a poor prognosis w/ resection;
- Technical Pearls:
-
surgery on growth plates
- interposition of fat is easiest and most commonly used agent to prevent bone bridge formation (alternatives
include silastic, methyl methacrylate, or free epiphysis);
Partial physeal growth arrest: treatment by bridge resection and fat interposition.
Surgical treatment of partial closure of the growth plate.
A. Langenskiold.
J. Pediatric Orthop. Vol 1. 1989. p 3-11.
Partial growth plate arrest and its treatment.
HA Peterson.
J. Pediatric Orthopedics.
Vol 4. 1984. p 246-258.
Operative correction of partial epiphyseal plate closure by osseous bridge resection and silicone rubber implant.
An experimental study in dogs.
RW Bright.
JBJS Vol 56(4) 1974. p 655-664.
An operation for partial closure of an epiphyseal plate in children, and its experimental basis.
A Langenskiold.
JBJS. Vol 57(3)-B. 1975. p 325-330.
Secondary Tethers After Physeal Bar Resection: A Common Source of Failure?
