Dallek M, Lorke D, Meyer-Pannwitt U, Jungbluth K H
Abteilung für Unfallchirurgie, Chirurgischen Universitätsklinik, Hamburg-Eppendorf.
Unfallchirurgie. 1988 Apr;14(2):57-63.
Macerated epiphyses of the growing infant bone exhibit an irregular surface which can already be observed at the macroscopic level. Polarizing microscopy demonstrates extended zones of bone resorption on the cortical surface, deductable from numerous lacunae of Howship. Ensuing experimentally induced epiphysiolyses, cortical bone fragments adhering to the inner surface of the periosteum are demonstrable by scanning electron microscopy. Having been torn out of the bone together with the periosteum, these cortical fragments leave corresponding defects on the bone surface. Due to the remodelling of the bone, involving the readjustment of the shape of the extremity, the attachment of the periosteum is relatively poor in the metaphyseal region of the growing bone. The influence of pathological forces can therefore easily cause a detaching of the periosteum in this region. The latter results in a significant weakening of the epiphyseal fastening in the zone between the epiphyseal plate and the metaphysis. The patterns of injury in the region of the growth plate are therefore essentially determined by the varying attachment of the periosteum to the metaphysis.
正在生长的婴儿骨骼的浸软骨骺呈现出不规则的表面，这在宏观层面就已能观察到。偏光显微镜显示皮质表面存在广泛的骨吸收区域，可从众多豪氏陷窝推断得出。随后的实验性骨骺分离显示，通过扫描电子显微镜可观察到附着于骨膜内表面的皮质骨碎片。这些皮质碎片与骨膜一同从骨上撕下，在骨表面留下相应的缺损。由于骨的重塑，包括肢体形状的重新调整，在正在生长的骨的干骺端区域，骨膜的附着相对较差。因此，病理力的影响很容易导致该区域骨膜的分离。这会导致骨骺在骨骺板和干骺端之间区域的固定显著减弱。因此，生长板区域的损伤模式基本上由骨膜与干骺端的不同附着情况决定。
