Marsh James S, Polzhofer Gert K
Yale University School of Medicine, Department of Orthopaedics and Rehabilitation, New Haven, CT, USA.
J Pediatr Orthop. 2006 Mar-Apr;26(2):255-9. doi: 10.1097/01.bpo.0000218533.43986.e1.
Thirty-seven central physeal bars were removed with an arthroscopically assisted technique. Thirty children (32 cases) have been followed to maturity or physeal closure. There were 19 boys and 11 girls, aged 4-14 years (mean, 9.5 years). Site of arrest was distal femur (15), proximal tibia (9), distal tibia (6), and distal radius (2). Mean follow-up was 6.5 years (range, 2-12 years). Adequate longitudinal growth was realized in 21 patients (70%) just after bar resection. Five patients (17%) required osteotomy, lengthening, or epiphysiodesis in addition to bar resection. In 4 patients (13%), bar resection failed. Failures occurred in those patients whose source of growth arrest was infection (3) or degree of physeal trauma approached 50% (1 case). This is the first series that studies and documents the efficacy of the arthroscope in central physeal bar resection. It provides the best visualization with minimal morbidity. The technique is described, including a discussion of technical tips and pitfalls.
采用关节镜辅助技术切除了37根中央骺板骨桥。30名儿童（32例）随访至骨骼成熟或骺板闭合。其中男孩19名，女孩11名，年龄4 - 14岁（平均9.5岁）。骨桥阻滞部位为股骨远端（15例）、胫骨近端（9例）、胫骨远端（6例）和桡骨远端（2例）。平均随访6.5年（范围2 - 12年）。21例患者（70%）在骨桥切除后即实现了足够的纵向生长。5例患者（17%）除骨桥切除外还需要截骨、延长或骺板固定术。4例患者（13%）骨桥切除失败。失败发生在生长阻滞源为感染的患者（3例）或骺板创伤程度接近50%的患者（1例）中。这是首个研究并记录关节镜在中央骺板骨桥切除术中疗效的系列研究。它以最小的发病率提供了最佳的可视化效果。文中描述了该技术，包括技术要点和陷阱的讨论。
