The injury of the epiphysis or epiphyseal plate produces undesirable effects on the normal growth of the bone, such as bone bridge, growth arrest and angular deformity. Authors performed vascularized fibular epiphysis and epiphyseal plate transplantation in 7 years old girl, who received the excision of the exostosis on distal ulna, followed by progressive varus deformity of right forearm and growth arrest of distal ulna. With follow
Congenital Abnormalities ; Epiphyses ; Exostoses ; Female ; Forearm ; Growth Plate ; Humans ; Methods ; Transplantation ; Ulna

OBJECTIVE: To realize the automated assessment of the levels of epiphysis of distal radius and ulna by support vector machine (SVM). METHODS: The X-ray films of the left wrist joints were taken from 140 teenagers aged from 11 to 19 years old as training samples. The levels of epiphysis of distal radius and ulna were divided into five developmental levels. Each level contained 28 samples. Another 35 cases were selected as independent verifying samples. SVM classification models of the five developmental levels of epiphysis of distal radius and ulna were established. The internal cross validation was made by leave one out cross validation (LOOCV), while the external validation was made by histogram of oriented gradient (HOG), and then the accuracy (PA) of testing results was calculated, respectively. RESULTS: The PA of SVM, LOOCV and HOG of distal radius epiphyseal level were 100%, 78.6%, and 82.8%, respectively; whereas the PA of SVM, LOOCV and HOG of distal ulna epiphyseal level were 100.0%, 80.0% and 88.6%, respectively. CONCLUSION The SVM-based automatic models of the growth stage of distal ra- dius and ulna appear to have certain feasibility, and may provide a foundation for software development of bone age assessment by forensic medicine.
Adolescent ; Bone Development/physiology* ; Child ; Epiphyses/growth & development* ; Female ; Humans ; Image Processing, Computer-Assisted/methods* ; Male ; Radius/growth & development* ; Support Vector Machine ; Ulna/growth & development* ; Wrist/growth & development* ; Wrist Joint/growth & development* ; Young Adult

Forearm bone fracture is a common injury in childhood. But there are many difficult problem to solve in treatment of the forearm bone fractures which are not encountered in the treatment of fracture of the other long bone. Forearm bone fracture in children differ from those in adult in a number of ways. The rapidity of healing, fuctional recovery together with the frequency of delayed or nonunion consitute the main features. More interesting, a deformity resulting from malunion may correct as bone growth proceeds. From August, 1973 to July, 1983, we have reviewed 66 cases of forearm bone fractures under 14 year old and which were treated in the Department of Orthopedic Surgery, Hanyang University Hospital. The results were as follows:1. 56 cases(84.8%) were male and most cases occured in school age. 2. 40 cases(60.7%) were both forearm bone fractures and most common site of the fracture was the distal 1/3. 3. The most common cause of the fractures was falling from height. Simple fracture was most common and greenstick fracture was next. Closed fractures were 61 cases (92.4%) and open fractures were 5 cases (7.6%) . 4. In roentgenologically, the younger the child was, the more rapid the duration of bone union was. Average duration of roentgenological union in conservative group was 8. 1 weeks, and that in operative group was 10. 1 weeks. So conservative group was more rapid in roentgenological bone union than operative group. 5. Accarding to the follow study of remodelling, the young the child and the nearer the fracture line was to the epiphyseal plate, the greater the potentialities for spontaneous correction were. 6. 62 cases (94.0%) showed excellent fuctionat result. According to 4 cases (6.0%) which showed good fuctional result, posterior angulation 17 degree, anterior angulation 15 degree and medial angulation 17 degree after reduction became more than 10 degree after remodelling.
Accidental Falls ; Adult ; Bone Development ; Child ; Clinical Study ; Congenital Abnormalities ; Forearm ; Fractures, Bone ; Fractures, Closed ; Fractures, Open ; Growth Plate ; Humans ; Male ; Orthopedics ; Radius ; Ulna

Vitamin D hydroxylation-deficient rickets type 1A (VDDR1A) is an autosomal recessively-inherited disorder caused by mutations in CYP27B1 encoding the 1α-hydroxylase enzyme. We report on a female patient with VDDR1A who presented with hypocalcemic seizure at the age of 13 months. The typical clinical and biochemical features of VDDR1A were found, such as hypocalcemia, increased alkaline phosphatase, secondary hyperparathyroidism and normal 25-hydroxyvitamin D3 (25(OH)D₃). Radiographic images of the wrist showed metaphyseal widening with cupping and fraying of the ulna and distal radius, suggesting rickets. A mutation analysis of the CYP27B1 gene identified a homozygous mutation of c.589+1G>A in the splice donor site in intron 3, which was known to be pathogenic. Since that time, the patient has been under calcitriol and calcium treatment, with normal growth and development. During the follow-up period, she did not develop genu valgum, scoliosis, or nephrocalcinosis.
25-Hydroxyvitamin D3 1-alpha-Hydroxylase* ; Alkaline Phosphatase ; Calcifediol ; Calcitriol ; Calcium ; Female ; Follow-Up Studies ; Genu Valgum ; Growth and Development ; Humans ; Hyperparathyroidism, Secondary ; Hypocalcemia ; Introns ; Nephrocalcinosis ; Radius ; Rickets* ; RNA Splice Sites ; Scoliosis ; Seizures ; Ulna ; Vitamin D* ; Vitamins* ; Wrist