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At least 199 records · Page 11Linked to original sources

PubMed1981

Spina bifida and unilateral focal destruction of the distal femoral epiphysis.

Focal destruction of the postero-lateral distal femoral epiphysis was present on radiographs in two children with spina bifida and objective lower limb sensory loss. Each patient presented with painless swelling of the knee. In one patient the epiphysis showed sclerosis and fragmentation associated with a defect. In the second patient the destructive change was the dominant radiographic abnormality and simulated bone tumor. Computed tomography in this patient showed a bone fragment occupying the defect suggesting epiphyseal fracture. The lesion in each patient was believed to be traumatic in origin and to represent a stage in the development toward neuropathic arthropathy.

Child, Preschool↗

PubMed1983

Developmental disorders of the proximal epiphysis of the hallux.

The development and developmental variation of the proximal epiphysis of the hallux have been studied in 1,500 children who presented to the Emergency Department with minor injuries. An abnormality was present in 3.5% of the children representing epiphyseal fragmentation, sclerosis, cone-shaped epiphysis, and trauma. Those subjects with developmental anomalies were reviewed clinically and 25% of those with epiphyseal fragmentation were found to be suffering from hallux rigidus. The radiological features and clinical considerations are presented.

Adolescent↗

PubMed1976

[Deformity and arthrosis in slipped upper femoral epiphysis (author's transl)].

X-rays of 104 slipped upper femoral epiphysis (without reduction of epiphysis and complications) showed pathological datas of the hip joints (ACM-angle, CE-angle, Hüftwert) in one third of the cases in the beginning and 60% until 12 years later. With higher degree of slip the arthrosis increase, but not the pathological datas of the hip joint. There is no dependence between deformity of the hip and arthrosis. Apparently the articular cartilage necrosis partially determine the development of arthrosis.

Adolescent↗

PubMed1991

Trauma involving the proximal tibial epiphysis.

Thirty injuries involving the proximal tibial epiphysis were treated during a period of 28 years. The epiphysis was displaced in 16 cases (53%). Three patients presented with peripheral ischemia on admission, and one patient with associated ipsilateral femoral fracture developed delayed thrombosis of the popliteal artery. The treatment results were satisfactory in 21 of the 27 (74%) who were reassessed according to Shelton's evaluation criteria after an average post-traumatic interval of 11.6 years. Three of the six patients with unsatisfactory outcome had a discrepancy in leg length of more than 2.5 cm after concomitant ipsilateral fracture of the femur or the tibia. One patient had a positive 3-cm anterior drawer sign, one patient had a 10 degree valgus deformity of the tibia, and one had to undergo above-knee-amputation because of delayed diagnosis of the vascular lesion.

Adolescent↗

PubMed1995

Slipped capital femoral epiphysis during treatment with recombinant human growth hormone for Turner syndrome.

Recombinant human growth hormone has recently been used to treat the short stature of Turner syndrome. However, this therapy may induce slipped capital femoral epiphysis, since the epiphyseal plate widens and becomes weak through either growth hormone or hypogonadism. This report shows that a slipped capital femoral epiphysis occurred during this treatment for an 11-year-old girl who was suffering from Turner syndrome. Thus, these patients who are being treated with growth hormone should be carefully observed.

Child↗

PubMed1980

Injuries of the distal radial epiphysis.

From 1964 to 1971 76 children with injuries of the wrist near the radial epiphysis were treated. On this occasion secondary injuries of the ulnar epiphysis, the styloid process ulnae, as well as concommitant bend-fractures of the distal ulna were found. Thirty-one of the patients were able to undergo a clinical and X-ray follow-up program. Restricted movements were not found; however radiologically deviations especially dorsally up to 15 degrees were found. In 5 concommitant strain fractures of the styloid process ulnae 4 pseudarthrotic healings of these strain fractures could be seen. During the follow-up these patients complained of pain after extended periods of utilisation or work involving the wrist. In 2 more patients, also complaining of pain after longer usage of the wrist joint, no objective cause could be found. The possibility of a posttraumatic structural disturbance in the distal radio-ulnar joint is discussed.

Athletic Injuries↗

PubMed1984

Slip of the capital femoral epiphysis: revival of a method of assessment.

A simple and exact method for evaluation of suspected or overt slip of the femoral capital epiphysis is revived. This procedure gives an estimate of all degrees of abnormality from the early stages to those with gross deformity. In our experience slip of the femoral capital epiphysis is always posterior and in approximately 80% of cases bilateral. Therefore, both hips should be examined whenever this condition is suspected. The method provides for examination of each hip separately. Strict adherence to the procedure also provides a precise way of assessing the femoral anteversion angle, significant in many orthopedic disorders. For the latter purpose access to a particular nomogram is mandatory.

Epiphyses, Slipped↗

PubMed1988

Effect of vitamin D status on the activity of carbonic anhydrase in chicken epiphysis and kidney.

Chickens were raised for 6 weeks from the date of hatch under red light on a vitamin D-free diet; controls were given an oral vitamin D supplement. Vitamin D-deficient animals showed decreased total serum calcium concentration and decreased DNA content in epiphysis and kidney homogenates. In calcifying epiphysis, total carbonic anhydrase (CA) activity was decreased, but activity per microgram DNA was slightly increased and specific activity was double that of the controls. Polyacrylamide gel isoelectric focusing after preparation of the enzyme showed a picture similar to that seen after parathyroid hormone (PTH) administration in chicks; therefore, this could be considered a secondary hyperparathyroidism. The CA activation was not seen in the kidney which can be explained by induction of an endogenous inhibitor protein of the cyclic AMP-dependent protein kinase exclusively in the kidney in vitamin D deficiency. In an additional experiment, chickens were raised for 3 weeks from the date of hatch under red light on a vitamin D-free diet. Daily oral substitution by different vitamin D metabolites (1,25(OH)2D3, 25OHD3, 24,25(OH)2D3) over 7 days led to CA activation compared with controls probably by restoring protein kinase activity in the kidney. Our results show that CA activity is inversely correlated with serum calcium concentrations which is in agreement with a regulatory mechanism recently proposed by us.

24,25-Dihydroxyvitamin D 3↗

PubMed2002

[Treatment of acute slips and clinical results in slipped capital femoral epiphysis].

In looking at the pathoanatomy of slipped capital epiphysis, it is important to appreciate that the articular cartilage ruptures at the level of the physis as the articular cartilage also covers part of the femoral neck metaphysis. As a consequence, smoothness is lost and already with mild slips the irregularities may injure the acetabular cartilage structures and may cause tears of the labrum. Principally therefore an open revision and restoration of the anatomy as perfectly as possible is needed. The technique for open reduction was developed by Dunn in 1964 and then refined by Ganz in 1997 applying new anatomical vascular studies. However, the long-term data on the "conservative" approach of only using transfixation to avoid further slipping show relatively good results and long-term studies of a more aggressive open approach will be needed to show evidence of further improvement. For the more severe cases, restoration of the correct anatomy by open reduction or improved axial relationships by more distant osteotomies have already been proven to give better results. Besides the extent of the slip, it is important to consider whether the slip is acute or chronic or acute and chronic. So far there are no data showing that the surgical treatment of slipped capital femoral epiphysis must be made on an emergency basis. However, prevention of further slips, e.g., by supine transport, is to be considered an emergency.

Adolescent↗

PubMed2002

[Results of treating slipped capital femoral epiphysis by pinning in situ].

The primary aim in treatment of chronic SCFE consists of immediate stabilization of the epiphysis to prevent further slipping. For mild degrees of slipping (<30 degrees ), pinning in situ is the treatment of choice. With slips between 30 and 50 degrees, the decision should be based on individual factors (age, functional limitation of the hip joint) whether pinning in situ is sufficient or whether an additional intertrochanteric osteotomy according to Imhäuser should be performed.The choice of implant should ensure a safe and stable connection between the epiphysis and the femoral neck without resulting in a substantial impairment of growth of the femoral neck due to premature closure of the growth plate. Since 1982 we have used K wires for in situ pinning of the affected hip as well as for prophylactic pinning of the nonaffected hip with a low complication rate. In a clinical and radiological study, 65 patients with a chronic slip of less than 50 degrees could be assessed after in situ pinning. Almost 75% were pain-free after a follow-up interval of 9.8 years, and 92% achieved a good or very good result according to the criteria of the Iowa hip score, the mean score being 95.1 points. According to the radiological score of Schulitz, five patients (7.7%) demonstrated a grade I osteoarthritis. One patient showed a partial necrosis of the femoral head; chondrolysis was not observed.

Adolescent↗

PubMed2002

The blood supply of the growth plate and the epiphysis: a comparative scanning electron microscopy and histological experimental study in growing sheep.

The blood supply of the growth plate has been described in the late 50s and early 60s, and there was controversial discussion about the existence of transphyseal vessels. The vascular supply of growth plate and epiphysis of the proximal tibia was reinvestigated using a modern technique, the Mercox-perfusion method, in six sheep aged 6-24 weeks. A comparison was made among pure perfusion specimens, the corrosion casts, and histological sections. The metaphyseal, epiphyseal, and perichondral blood supply systems were confirmed. However, there was evidence of regular transphyseal anastomoses between the metaphyseal and epiphyseal system. Based on the histological arrangement of the blood vessels, the arterial blood flow would appear to be from the metaphysis to the epiphysis. The existence of transphyseal arterial vessels originating metaphyseally and seen both in cast preparations and histological sections was added to the present description of the blood supply of the growth plate. Age-related differences in the vascularization of the growth plate were not found in this study.

Animals↗

PubMed1998

Slipped capital femoral epiphysis. A report of 4 cases occurring in one family.

We describe slipped capital femoral epiphysis in 4 members of a black, obese family, who were all first-degree relatives. The aetiology of slipped capital femoral epiphysis is unknown, although it is thought to be multifactorial. Genetic predisposition and environmental factors have been associated with the condition. A familial incidence with at least two cases in the same family has been reported. In epidemiological studies, this incidence ranges from 3% to 35%. Our cases were investigated in an attempt to find a possible aetiological genetic factor. A genetic predisposition with an autosomal dominant pattern of transmission is suggested, although environmental variables must be considered as provocative factors.

Adolescent↗

PubMed2005

Chondrocytes are released as viable cells during cartilage resorption associated with the formation of intrachondral canals in the rat tibial epiphysis.

The development of cartilage canals is the first event of the ossification of the epiphyses in mammals. Canal formation differs from vascular invasion during primary ossification, since the former involves resorption of resting cartilage and is uncoupled from bone deposition. To learn more about the fate of resorbed chondrocytes during this process, we have carried out structural, cell proliferation, and in situ hybridization studies during the first stages of ossification of the rat tibial proximal epiphysis. Results concerning the formation of the cartilage canals implied the release of resting chondrocytes from the cartilage matrix to the canal cavity. Released chondrocytes had a well-preserved structure, expressed type-II collagen, and maintained the capacity to divide. All these data suggested that chondrocytes released into the canals remained viable for a specific time. Analysis of the proliferative activity at different regions of the cartilage canals showed that the percentage of proliferative chondrocytes at areas of active cartilage resorption was significantly higher than that in zones of low resorption. These results are consistent with the hypothesis that resting chondrocytes surrounding canals have a role in supplying cells for the development of the secondary ossification center. Since released chondrocytes are at an early stage of differentiation greatly preceding their entry into the apoptotic pathway and are exposed to a specific matrix, cellular, and humoral microenvironment, they might differentiate to other cell types and contribute to the ossification of the epiphysis.

Acid Phosphatase↗

PubMed2006

Early reversible ischemia of femoral head epiphysis in piglets on gadolinium-enhanced MRI: an experimental study.

The purpose of this study is to demonstrate if Gadolinium-enhanced MRI can detect early reversible ischemia of the femoral head epiphysis caused by hip hyper-abduction in piglets. Between 3 and 6 h consistent hyper-abduction, gadolinium-enhanced MRI was performed in 20 femoral heads of 10 piglets. After completion of MRI scan, the piglets were allowed to ambulate freely for 1 or 7 days and re-imaged. The enhanced-MRI results of epiphyseal and physeal cartilage and the secondary center of ossification were observed. MRI appearances and histological findings were compared. On Gadolinium-enhanced MRI, decreased or absent enhancement was seen in 14 cartilaginous epiphyses of all 20 femoral heads. Reperfusion was completed in 10 of 14 femoral heads after one day of ambulation and in the rest 4 after 7 days of ambulation. Gadolinium-enhanced MRI can identify early ischemia and its reversal of the capital femoral epiphysis induced by hip hyper-abduction.

Animals↗

PubMed1975

Severe irreducible slipping of upper femoral epiphysis: a review of 14 cases treated by subtrochanteric osteotomy.

Children with signs of slipping of the upper femoral epiphysis often present in an Accident Service, particularly after a severe, acute slip. In some cases the displacement is irreducible and correction of the persistent deformity by either cervical or trochanteric osteotomy is required. This paper is a review of 14 cases of irreducible slipped upper femoral epiphysis treated by subtrochanteric osteotomy. Clinical and radiological assessment of these cases some years later shows a high proportion of successful results and suggests that this is a safe and satisfactory method of treating this condition.

Child↗

PubMed1979

Chondroitin sulfates of the epiphysial cartilages of different mammals.

1. The distribution chondroitin 4- and 6-sulfates in the epiphysial cartilages of several mammals are reported. 2. Chondroitin 6-sulfate is present in higher relative proportion in articular surfaces of young and adult epiphysial cartilages in most of the mammals studied. 3. Exception to this was found in some species of the order Rodentia in which chondroitin 4-sulfate was almost the only chondroitin present in young and adult cartilages. 4. These and other results suggest that chondroitin 4-sulfate may be an important component for the calcification process, whereas chondroitin 6-sulfate seems to be related to the integrity of the articular surfaces.

Aging↗

PubMed1993

Dislocation of the distal phalanx epiphysis in toddlers.

Two cases of physeal fracture dislocation of the distal phalanx are reviewed. Each injury occurred in a toddler, was originally undiagnosed, and appeared years later as a dorsal mass in a fore-shortened digit with decreased distal interphalangeal joint motion. In each case x-ray films revealed a dislocated epiphysis, accounting for the enlarging dorsal prominence and the phalangeal growth disturbance. These cases demonstrate that dislocation of the distal phalanx epiphysis can occur with a crush injury and may be difficult to detect before development of the ossification center. Careful physical examination and a high index of suspicion will increase the likelihood of early diagnosis. Early open reduction may prevent the late complications of deformity and stiffness.

Child↗

PubMed1995

Adaptation of non-growing former epiphysis and metaphyseal trabecular bones to aging and immobilization in rat.

No data exit for distal tibia (DT), a bone site with growth plate closure at 3 months of age and with very low trabecular bone turnover rate. The purpose of this study was to characterize the response of DT to aging and immobilization (IM) in 6 to 16.5 month-old female rats. One hundred and forty six 6 month-old Sprague-Dawley rats were divided into aging controls and right hindlimb immobilization (RHLI) groups. The right hindlimb was immobilized against the abdomen with elastic bandages. Rats were sacrificed serially from 6 to 16.5 months old at intervals of 2 to 8 weeks. The histomorphometric study was performed on areas of former epiphyseal and metaphyseal trabecular bone of DT. No changes on bone mass or architecture were found in aging controls throughout the study. There was a decrease in bone mass of the former epiphysis after 3.5 months of IM due to resorption exceeding formation. Then it reverted to the aging control level at 4 months post IM. At the former metaphyseal site, significant bone loss (-19%) was observed as early as two weeks after IM. The peak bone loss (-54%) was reached at 1.5 months after IM and plateaued thereafter. The bone loss was mainly due to the reduction of trabecular thickness although trabecular number decreased significantly after 3.5 months IM. These results suggest that both former epiphysis and metaphyseal trabecular bones in DT can quickly adapt by losing bone to immobilization.

Adaptation, Physiological↗