Sevil-Kilimci Figen, Cobanoglu Mutlu, Ocal Mehmet K, Korkmaz Deniz, Cullu Emre
Department of Anatomy, Faculty of Veterinary Medicine.
Department of Orthopedics and Traumatology, Faculty of Medicine, Adnan Menderes University, Aydin.
J Pediatr Orthop. 2019 Jul;39(6):289-294. doi: 10.1097/BPO.0000000000001004.
There are studies on the use of oblique plate over epiphyses for rotational deformities but the effects of this method on bone are not yet known. The purpose of this study was to determine the effect and rebound effect of rotational-guided growth on the geometries of the tibial plateaus and menisci in a rabbit model of tibial axial rotation.
Thirty male rabbits were 6 weeks old when medial and lateral plates were applied to the proximal tibias of the left side. After 4 weeks, 15 rabbits were euthanized (group 1), and the plates from the tibias of the remaining 15 rabbits (group 2) were removed. The rabbits in group 2 were euthanized 4 weeks later.
In the rabbits of group 1, the most striking differences were a decrease in the lateral tibial slope (from 28.3 to 10.8 degrees) and decrease in the ratio of the lateral plateau covered by the meniscus (from 71.9% to 61.3%). After removing the plates (group 2), the observed values of the rebound effects were 25.9 and 29.8 degrees for the lateral tibial slope, and 76.5% and 77.2% for the ratio of the lateral plateau covered by the meniscus. However, the meniscal geometries continued to change.
The rotational-guided growth provided by using plates caused a change in the tibial plateau geometry, and the rebound effect, except in the meniscal geometry, was observed after removing the plates in the growing period of the rabbits. Rotational-guided growth for the restoration of tibial axial rotation deformities may be suggested after determining the clinical effects of the increasing meniscal variables.
Clinical relevance: the rotational-guided growth needs close follow-up because of possible changes in anatomy of the bone.
有关于使用斜板跨越骨骺治疗旋转畸形的研究，但该方法对骨骼的影响尚不清楚。本研究的目的是在兔胫骨轴向旋转模型中确定旋转引导生长对胫骨平台和半月板几何形状的影响及反弹效应。
30只雄性兔6周龄时在左侧胫骨近端应用内侧和外侧板。4周后，15只兔安乐死（第1组），其余15只兔（第2组）的板从胫骨上移除。第2组兔在4周后安乐死。
在第1组兔中，最显著的差异是胫骨外侧斜率降低（从28.3度降至10.8度）以及半月板覆盖的外侧平台比例降低（从71.9%降至61.3%）。移除板后（第2组），观察到的胫骨外侧斜率反弹效应值分别为25.9度和29.8度，半月板覆盖的外侧平台比例反弹效应值分别为76.5%和77.2%。然而，半月板几何形状继续变化。
使用板提供的旋转引导生长导致胫骨平台几何形状改变，并且在兔生长期间移除板后观察到了除半月板几何形状外的反弹效应。在确定半月板变量增加的临床效果后，可能建议采用旋转引导生长来恢复胫骨轴向旋转畸形。
临床相关性：由于骨骼解剖结构可能发生变化，旋转引导生长需要密切随访。
