The radius including the proximal epiphysis was transferred in puppies. Growth in the vascularized long bone grafts in growing animals was significantly greate than in the non-vascularized grafts, not equal to normal growth. In the non-vascularized grafts the epiphyses closed one month postoperatively, compared to 5 months in the vascularized grafts and 6 months in the normal controls. This data suggests that, in transplantation of growing bone, revascularization is essential to maximize continuing growth. This study is an initial step in the development of a technique for the transfer of a free vascularized growth plate. This information would be beneficial in predicting growth patterns of free vascularized bone transfers for growth disturbances, congenital anomalies and trauma in youth.
Animal ; Bone Development* ; Bone Transplantation* ; Dogs ; Epiphyses/surgery* ; Radius/surgery*

OBJECTIVES: To study the injury manners of Bennett fracture and Rolando fracture and explore its identification principle of the first metacarpal base fractures. METHODS: Totally 31 cases of Bennett fracture and Rolando fracture were collected. The injury manners of cases of 19 Bennett fractures and 12 Rolando fracture were classified, and various injury manners were analysed statistically. RESULTS: The injury manners of the cases of 19 Bennett fracture and 12 Rolando fracture were divided into three types, including the first metacarpus hit hard objects during a punching, the first metacarpus hit hard objects when making fists and fell, or the first metacarpus was punched by hard objects when making fists. CONCLUSIONS The injury mechanism of Bennett fracture and Rolando fracture is formed by a force on the first metacarpus when making fists, which transmits to the basilar part along the vertical axis of metacarpus. The inference of injury manners should be focused on the confirmation of entrusted matters.
Epiphyses ; Fracture Fixation, Internal/methods* ; Fractures, Bone/surgery* ; Humans ; Joint Dislocations/surgery* ; Metacarpus/injuries* ; Thumb/injuries*

Adolescent ; Bone Screws ; Child ; Epiphyses ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; Humans ; Male ; Tibia ; injuries ; surgery ; Tibial Fractures ; surgery

Bone Screws ; Child ; Device Removal ; methods ; Epiphyses, Slipped ; surgery ; Female ; Humans

Combined type III Monteggia fracture dislocation and ipsilateral distal radial epiphyseal fracture is a very rare injury. Because of difficulty in performing the proper clinical evaluation of a child in an acute injury state, one of the components of this combined injury may be missed. We report a ten-year-old male child with this kind of injury where the Monteggia lesion was initially missed at the emergency department. Later we found the combined epiphyseal fracture of distal radius and Monteggia lesion in the ipsilateral side of the same limb which was managed by closed reduction and K-wire fixation. Bony union as well as wrist and elbow motion was complete 3 months after surgical intervention.
Child ; Epiphyses ; diagnostic imaging ; injuries ; Humans ; Male ; Monteggia's Fracture ; diagnostic imaging ; surgery ; Probability ; Radius Fractures ; diagnostic imaging ; surgery

OBJECTIVETo investigate the feasibility and clinical effects of titanium elastic nail (TEN) for treatment of proximal radius epiphyseal injuries of O'Brien type III.

METHODSFrom October 2008 to November 2009,19 patients with proximal radius epiphyseal injuries of O'Brien type III were treated with internal fixation, including 13 males and 5 females with an average age of 8.3 years old ranging from 6 to 12 years. The average time from injury to surgery was 3.5 days (2 to 7 days). The reduction situation after operation was assessed by Métaizeau criteria, and the elbow function after operation were evaluated by Broberg-Morrey elbow score.

RESULTSAll patients were followed-up for 8.7 months in average (ranged 6 to 12 months). No infection, TEN brokage, skin bursting and other complications occurrenced. According to Métaizeau criteria, the results were excellent in 7 cases, good in 10 cases and fair in 2 cases. The Broberg-Morrey score rose from preoperative (47.3 +/- 5.1) to (86.6 +/- 6.3) at 3 months followed-up (t=139.17, P=0.0002); the outcome was excellent in 7 cases, good in 9 cases, and fair in 3 cases.

CONCLUSIONInternal fixation with TEN in treatment of proximal radius epiphyseal injuries of O'Brien type III has a limited invasion, cosmetic beauty, safety and reliability advantages. This technique provides a reliable alternative in proximal radius epiphyseal injuries of O'Brien type III.

Bone Nails ; Child ; Elasticity ; Epiphyses ; injuries ; surgery ; Female ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Radius Fractures ; surgery ; Titanium ; Treatment Outcome

OBJECTIVETo evaluate the results of surgical treatment for moderate or severe slipped capital femoral epiphysis (SCFE) using modified Dunn procedure through the approach of surgical hip dislocation at the interval of minimum 12 months follow-up.

METHODSFrom November 2011 to June 2013, 6 patients (7 hips) with SCFE were treated in department of pediatric orthopedics, Hospital Affiliated to Shanghai Jiaotong University School of Medicine, they all had trauma history. The patients were aged from 10-15 years, mean 13.6 years. The duration of symptoms ranged from 4 to 35 days, average 14.2 days. The degree of slip was averagely 45% (25%-55%). In 6 patients (except right side of 1 case was treated in situ with cannulated screws) were surgically treated using modified Dunn procedure through the approach of surgical hip dislocation. Postoperatively the brace was used for immobilizing the hip for 4 weeks, then 4 weeks of bed traction combined with rehabilitation program of hip joint activity. Eight weeks later, the gradual touchdown weight bearing was being allowed.

RESULTSThe follow-up time ranged from 12 to 30 months, average 23.8 months. Six patients have been able to walk without crutches, no obvious limp. X-ray film showed femoral epiphysis line on the bit of good recovery, no appearance of avascular necrosis of the femoral head, joint space was normal. The Harris score of hip evaluation was 94.7 averagely, ranging 85-100, at the time of last follow-up.

CONCLUSIONSApplication of surgical treatment for moderate or severe SCFE with open reduction through the approach of surgical hip dislocation is a valid alternative method. The femoral head epiphysis can be capable of restoring anatomy, at present no case occurred avascular necrosis, and patients are satisfied with the function of the hip joint.

Adolescent ; Child ; Femur ; Femur Head ; Femur Head Necrosis ; Hip Dislocation ; surgery ; Humans ; Orthopedic Procedures ; Slipped Capital Femoral Epiphyses ; Treatment Outcome

OBJECTIVETo evaluate the initial dislocation resistance of the pullout force of different material or different type of goats thoracic hemi-epiphyseal compression staples.

METHODSAccording to the measuring anatomic data of thoracic vertebra (T6 approximately T11) specimens in goats (age 2 approximately 3 months), we designed stainless steel staple whose original distances between two opened prone were 10 mm and three kinds of shape memory alloy (SMA) staples whose original distances between two opened prone were respectively 5.0, 6.5 and 8.0 mm. Four specimens were used and each was cut into three functional spinal units (FSU) of T6 - T7, T8 - T9 and T10 - T11, then FSU were redistributed. Stainless steel staples and SMA staples were implanted into both sides of FSU. There were four groups: group I was stainless steel staples. group II was SMA of 5.0 mm. group III was SMA of 6.5 mm. group IV was SMA of 8.0 mm. The peak force of pullout in each FSU was measured on 858 biomechanical test machine.

RESULTSThe peak force of group I was (20.62 +/- 9.15) N, group II was (74.18 +/- 8.81) N, group III was (51.28 +/- 5.44) N, group IV was (39.13 +/- 7.54) N. It is found that there were statistically different between all groups (P < 0.05). The peak force values of group I were lowest than others.

CONCLUSIONSDifferences of the initial dislocation resistance in different materials. SMA staples exhibit higher pullout force. Meanwhile, the pullout forces were also different between SMA staples, the smaller original distance the higher peak force of pullout.

Alloys ; Animals ; Bone Nails ; Epiphyses ; surgery ; Female ; Goats ; Materials Testing ; Mechanics ; Orthopedic Procedures ; instrumentation ; Stainless Steel ; Thoracic Vertebrae

BACKGROUND: The hemiepiphyseal stapling has both positive and negative effects on effective leg length. The purpose of this study was to analyze change in effective leg length after angular correction by hemiepiphyseal stapling, and to validate in clinical cases. METHODS: Mathematical analysis of a hemiepiphyseal stapling model was conducted. The induced formula was validated in 6 cases fulfilling the assumptions of the model. Anatomical parameters involved in this formula were measured in additional 21 cases undergoing hemiepiphyseal stapling or hemiepiphysiodesis. RESULTS: Effective leg length increased or decreased according to three parameters in this model: 1) limb length distal to the operated physis (L), 2) width of the operated physis (d), and 3) the amount of angular deformity to be corrected (theta). Actual change in effective leg length of 6 cases similar to this model coincided with the predicted change at least in its direction. L/d ratio was 4.82 +/- 0.51. CONCLUSIONS: Considering the narrow range of the L/d ratio, hemiepiphyseal stapling is likely to decrease effective leg length if the amount of angular correction is less than 10degrees, whereas to increase it if the amount of angular correction is larger than 16degrees. This should be taken into consideration when selecting the surgical method for angular deformity correction in skeletally immature patients.
Adolescent ; Child ; Epiphyses/growth & development/*surgery ; Female ; Genu Valgum/*surgery ; Genu Varum/*surgery ; Humans ; Leg Length Inequality/diagnosis/*etiology ; Male ; *Surgical Stapling/adverse effects

INTRODUCTIONSlipped capital femoral epiphysis is the most common hip problem in the adolescent age group. It can involve both hips, presenting itself bilaterally at first presentation or sequentially. The overall incidence of bilateral disease is variable, but the risk of occurrence is higher when there is underlying endocrinopathy, renal disease and obesity.

MATERIALS AND METHODSAmongst the 36 cases (44 hips) of slipped capital femoral epiphysis that we had, there were 8 cases of bilateral disease, of which 3 were bilateral sequential slips. A retrospective review of all case records and X-rays was done.

RESULTSAccording to Aadalen's criteria, the results were excellent or good in 37 hips, fair in 3 hips, and poor in 2 hips. Two patients were considered as treatment failure because of avascular necrosis. The incidence of bilateral slipped capital femoral epiphysis was 22.2%. The overall average age was 11.4 years. All cases of sequential involvement presented within 15 months of the initial slip. One patient had hypothyroidism (who also had a positive family history for slipped capital femoral epiphysis), while 91.6% were above the 75th percentile for weight. There was no statistically significant difference in age, sex, race, body mass index (BMI) and weight percentile distribution between patients with unilateral and bilateral disease.

CONCLUSIONSatisfactory outcomes can be expected in most patients treated for slipped capital femoral epiphysis. The risk of avascular necrosis is higher in unstable slips. The role of prophylactic contra-lateral pinning should be restricted to patients with hypothalamic-pituitary-ovarian axis disease, especially hypothyroidism.

Adolescent ; Bone Nails ; Child ; Epiphyses, Slipped ; complications ; prevention & control ; surgery ; Female ; Femur Head ; surgery ; Femur Head Necrosis ; etiology ; Humans ; Male ; Recurrence ; Treatment Outcome