J Am Podiatr Med Assoc. 2021 Mar 1;111(2). doi: 10.7547/20-021.
Longitudinal epiphyseal bracket is a rare ossification disorder of the short tubular bones. The affected bone becomes deformed as a result of the bracket. The normal growth pattern cannot occur, and when it affects the first metatarsal bone, hallux varus may develop with the abnormal growth pattern. We present such a 6-year-old patient who had undergone surgery at 6 months of age for hallux varus and polydactyly. The deformity had worsened gradually after the initial operation because of the overlooked longitudinal epiphyseal bracket. The patient was treated with surgical excision of the epiphyseal bracket, with corrective medial open wedge osteotomy and split transfer of the extensor hallucis longus tendon. The result was excellent at the 20-month follow-up. At an early age, patients who present with hallux varus must be checked for the epiphyseal bracket, which can be invisible on radiographs because of the chondral structure. Untreated or overlooked patients with epiphyseal bracket will need revision operations for recurrent deformities.
纵向骺板是一种罕见的短管状骨骨化障碍。由于骺板的存在，受影响的骨骼会变形。正常的生长模式无法发生，当它影响到第一跖骨时，可能会出现拇趾内翻的异常生长模式。我们报告了这样一位 6 岁的患者，他在 6 个月大时因拇趾内翻和多指畸形接受了手术治疗。由于忽略了纵向骺板，初始手术后畸形逐渐加重。患者接受了骺板切除术，内侧楔形截骨矫正和伸肌肌腱劈开转移术。20 个月随访时结果优良。对于早期出现拇趾内翻的患者，必须检查骺板，由于软骨结构，骺板在 X 线片上可能不可见。未治疗或被忽视的骺板患者需要进行翻修手术以矫正复发畸形。
