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Growth disturbance after osteomyelitis in a single femoral condyle was seen in seven infants followed by the author from infancy to maturity. Age at onset of infection was between 10 days and 4 weeks. In three cases the medial condyle was affected and in four the lateral. Angular deformity of 20-50 degrees of varus or valgus was present before correction by supracondylar osteotomy. In all seven cases the radiographic appearance before the first osteotomy was similar. Partial closure of the growth plate appeared in four cases at age 6, 7, 10 and 12 years, respectively, which was decisive for loss of growth in length. These children had 3-6 osteotomies before maturity. In three cases partial closure of the plate did not occur, progression of angulation was slow and only two femoral osteotomies were carried out. Restitution of the epiphysis and growth disturbance are unpredictable on the basis of radiographic findings during infancy. Partial closure of the growth plate may occur at the age of 4 years. Indications for correction of deformity and for epiphyseodesis in the other leg should be considered once or twice every year during the growth period.

A continuous 5-V peak-to-peak, 60 kHz capacitively-coupled sine wave signal was applied to the proximal tibial growth plate in fifteen 9-week-old male New Zealand white rabbits for 6 weeks. A pair of flexible stainless steel "injectrodes" was held in place medially and laterally on the surface of the proximal hindlimb in each rabbit by means of tape wrappings. The electrodes were connected to a 9-V battery-operated power unit carried in a dorsal pouch in a body vest worn by each rabbit. Control animals wore the identical apparatus, only the power unit was inactive. Small Tantalum markers were inserted into the anteromedial aspect of the proximal tibial metaphysis 1 cm distal to the proximal tibial growth plate in all of the animals, control and experimental, 2 weeks prior to the onset of electrical stimulation. The distance between the proximal lateral tibial spine and the Tantalum marker, between the Tantalum marker and the apex of the distal tibial intercondylar notch, and between the proximal tibial spine and the distal notch was measured from roentgenograms made at the time of bone marker insertion, at the time of electrode application to the limb, and at the end of the stimulation period. Results indicate that there was no significant difference in tibial lengths between the stimulated and control groups. There was significantly less total body weight gain in both the experimental and control animals than that which occurred in paired normal animals during the same period of time. This failure to thrive may be responsible for the resultant lack of longitudinal growth stimulation of the capacitive coupling.(ABSTRACT TRUNCATED AT 250 WORDS)

Magnetic resonance imaging (MRI) studies in two patients with congenital coxa vara revealed a widened growth plate with expansion of cartilage mediodistally between the capital femoral epiphysis and metaphysis. They did not reveal slippage. Histologic studies showed that the growth plate appeared to be composed merely of irregularly and scarcely distributed germinal cartilage cells with abundant matrix. The histologic studies resembled the histopathologic reports of metaphyseal chondrodysplasia Schmid type, but only with regard to the proximal femoral growth plate. Determination of the sulfur concentration of the cartilaginous matrix was within normal range.

When HEBP (1-hydroxyethylidene-1, 1-biphosphonic acid) was administered to young rats in large doses over a short period rickets was consistently produced. When HEBP was administered concomitantly with 1,25 (OH)2D3 or calcitonin (CT), calcification appeared in the growth-plate cartilage where there had been an increase in thickness due to the inhibition of calcification. This experiment was done in an attempt to clarify differences in the calcification-promoting mechanisms of 1,25 (OH)2D3 and CT. The serum alkaline phosphatase level was reduced in rats with an accelerated calcification following the administration of 1,25 (OH)2D3, but there was no reduction in the serum alkaline phosphatase level in rats in which the calcification was accelerated by the administration of CT. The mode of appearance of calcification in the growth-plate cartilage by 1,25 (OH)2D3 or CT differed, depending on the time of administration. These results suggest that mechanisms involved in the enhancement of calcification by 1,25 (OH)2D3 and CT differ in cases where rickets are induced by HEBP.

A bony bridge was created in the growth plates of young rabbits. Weekly computed tomography (CT) scanning was done in the axial (transverse) plane for 3 weeks. Transverse histological sections from the plate area were examined after 3 weeks. The CT image showed the exact location and extent of the sclerotic bony bridge. The area of the bony bridge as a percentage of the plate was measured from the CT image. Good correlation was found between the CT image and the histological section. This technique has been applied to children, and three such examples show accurate assessment of the growth plate.

The radiologic evaluation of growth plate injuries is vital to the surgical management of children with partial growth plate arrests. Plain film radiographs are of limited value, and in some cases, even high quality tomography does not provide adequate detail. Computed tomography (CT) can however provide a cross-sectional display and may also aid in defining the relative position of bone and cartilage in the affected area. This may prove invaluable to the surgeon in the planning of his operation. The vast majority of cases of partial growth arrest can be adequately examined by conventional means, but CT can provide additional information in cases where plain film examination is inadequate.

A case of chronic, progressive avulsion of the anterior superior iliac spine leading to the formation of a long, attenuated spur of bone in an 18-year-old black male break dancer is described. The mechanism of formation appeared to be repetitive avulsion from break dancing.

Proximal femoral focal deficiency is a rare congenital malformation, characterized by a failure of normal development of the proximal part of the femur. To our knowledge, there have been no reports on the histology of fetal growth plates that are affected by this disorder. To characterize this focal developmental anomaly further, we studied the histopathology of the growth plates and epiphyses from a twenty-one-week fetus with unilateral proximal femoral focal deficiency. Although the shape of the cartilaginous anlage of the fetus appeared normal, the growth plate of the proximal part of the involved femur was markedly abnormal. The major findings were: (1) striking failure of the proximal growth plate to migrate proximally, away from the central part of the diaphysis, and failure of formation of a normal growth plate; (2) failure of organization of proliferative and hypertrophic chondrocytes into longitudinal columns; (3) truncation of an immature hypertrophic zone that had abnormal septal architecture; and (4) disorganized vascular invasion with a honeycomb rather than a columnar pattern of primary trabeculae. In contrast, the histological characteristics of the growth plates from the distal part of the femur and from all other long bones were normal.

We analyzed the longitudinal growth of the distal tibial and fibular physes and the longitudinal displacement of the distal metaphysis and epiphysis of the fibula relative to the distal metaphysis and epiphysis of the tibia during growth using a roentgenstereophotogrammetric technique in eight children: six with a traumatic growth disturbance in one or both of the distal tibial and distal fibular physes and two with a normal ankle. In the normal ankles the distal fibular metaphysis moved distally in relation to the distal tibial metaphysis and the growth in the distal fibular physis was slower than that in the distal tibial physis. Growth arrest in the distal fibular physis and continued growth in the distal tibial physis resulted in distal displacement of the fibular metaphysis relative to the tibial metaphysis, probably due to traction on the distal ligaments of the fibula or more rapid growth in the proximal fibular physis than in the proximal tibial physis, or both. Valgus deformity of the ankle developed when the growth of the distal tibial physis exceeded the distal sliding of the fibula, as shown by the stereophotogrammetric analyses and orthoroentgenograms. Growth arrest in the distal tibial physis and continued growth in the distal fibular physis resulted in proximal sliding of the fibula, as shown by the roentgenstereophotogrammetric analyses and serial orthoroentgenograms. This mechanism compensated to some extent for the overgrowth of the fibula. Simultaneous growth arrest in both the distal tibial and the distal fibular physis was associated with movement of the distal end of the fibula in a distal direction relative to the tibia, probably due to the more rapid growth in the proximal fibular physis than in the proximal tibial growth plate. Therefore, growth arrest of the distal tibial or fibular physis may result in either proximal or distal sliding of the fibular metaphysis in relation to the tibial metaphysis. Probably growth arrest in the distal fibular physis has a less favorable prognosis than arrest in the distal tibial physis, because after tibial arrest proximal sliding of the fibula may compensate for overgrowth of the fibula better than distal sliding of the fibula can compensate for fibular arrest and overgrowth of the tibia.

Two girls with sex-linked hypophosphatemic rickets are described in whom premature fusion of the medial proximal tibial epiphyseal plate exacerbated lower-extremity bowing. Early recognition of this complication and appropriate surgical intervention--excision of the bony bridge in the growth plate, or epiphysiodesis of the still open portion of the growth plate--might prevent further shortening or deformity of the affected limb.

In order to determine if either the proteoglycans or collagen in the cartilagenous epiphyses of a Miniature Poodle with spondyloepiphyseal dysplasia were abnormal, the cartilage was dissociatively extracted in 4 M guanidine HCl in the presence of protease inhibitors and subjected to isopycnic cesium chloride dissociative density gradient ultracentrifugation. Dissociative extraction solubilized 97% of the uronic acid and 88% of the protein. Uronic acid distributed anomalously in the density gradient in that about 1/3 was recovered in each of the D1 (1.58 g/ml), D2 (1.49 g/ml) and D3 (1.44 g/ml) fractions. Proteoglycans in the D1, D2 and D3 fractions also eluted from Sepharose CL-2B columns in a manner indicative of monomers of a smaller apparent hydrodynamic size than those from normal canine growth plate or articular cartilage. D1, D2 and D3 monomers subjected to the sodium borohydride reaction followed by chromatography on a Sepharose CL-6B column yielded glycosaminoglycan chain molecular weights of 10,200 (D1), 7600 (D2) and 6200 (D3). High pressure liquid chromatography on a Whatman Partisil 10PAC column of the chondroitinase AC II digests of D1, D2 and D3 fractions revealed that 60% of the D1, 81% of the D2 and 88% of the D3 unsaturated disaccharides eluted in the delta DiOS-delta DiHA position. Subsequent HPLC of the unsaturated disaccharides on the Hypersil APS column resulted in the recovery of 97% of the nonsulfated unsaturated disaccharides in the delta DiOS position. Associative extraction in 0.5 M guanidine followed by associative gradient ultracentrifugation resulted in the recovery of 27% of the uronic acid in the aA1 and 47% in the aA2 fractions. Two dimensional SDS gel electrophoresis of the CNBr peptides of the collagen isolated by pepsin digestion and 0.9 M NaCl precipitation revealed type II collagen. This study has demonstrated that spondyloepiphyseal dysplasia in a Miniature Poodle is characterized by cartilage containing undersulfated chondroitin sulfate proteoglycan.

High-level gymnastic training may cause clinical and radiographic changes in the wrist. A case is reported demonstrating bilateral closure of the ulnar side of the distal radius epiphyseal plate in a patient with a history of high-level gymnastic training. Cumulative microtrauma to the ulnar side of the distal radius epiphyseal plate may cause premature closure leading to a Madelung-like deformity.

We investigated the feasibility in the dog of using transfers of the distal ulna into the radius either as growth plate replacements or as accessory growth plates in the diaphysis. Preliminary work determined the most satisfactory method of skeletal fixation. The experimental study showed that transfers used as growth plate replacements grew at almost normal rates, uniting with the recipient bone in a mean of 7.1 weeks. Transfers into the diaphysis initially nearly doubled the growth rate of the radius, although in the long-term results were unsatisfactory, because of fracture of the graft after a mean period of 8.2 weeks.

Twelve patients are reported in whom a unicameral bone cyst was found to involve the epiphysis or apophysis across an open growth plate. Nine patients showed pathologic fracture. In four patients a growth disturbance was found. A varying amount of varus angulation was present in most cases. No patient had functional impairment.

Skeletal growth is a dynamic process. A knowledge of the structure and function of the normal growth plate is essential in order to understand the pathophysiology of abnormal skeletal growth in various diseases. In this well-illustrated article, the authors provide a radiographic classification of abnormal growth plates and discuss mechanisms that lead to growth plate abnormalities.

Authors tried to find out a correlation between chronological age, inorganic phosphorus (P), calcium (Ca) and alkaline phosphatase (ALP) with some radiological signs obtained from a periodical study of different sexes and breeds (small-middle-large) of dogs right foreleg from weaning to the end of osseous growth. They confirmed the period when ossification centres come in sight. The first centre appears at 3 weeks of life (humerus) and the last one at 8-10 weeks (scapular tuberosity). Epiphyseal fusion begins with the accessory carpal bone (16-20 weeks). Osseous development finished around 40 weeks with the fusion of proximal humerus and radius epiphyseal plates. During the work the ALP and P serum decreased values were significant (p less than 0.001), but Ca were not significant (p less than 0.05). There were good correlations with chronological age and both P (r = 0.98) and ALP values (r = 0.90). There was none correlation between age and Ca. When the osseous growth finished, Ca and P reached adult levels, but ALP was still elevated.