Reismann B
Fortschr Med. 1978 Nov 9;96(42):2164-8.
In a clinical and experimental study two factors have been found to be most important for the increase of growth after fractures in childhood: 1. Trauma leads to changes of blood circulation in the epiphysis. Changes in oxygen tension cause morphometric alterations of cellular and intercellular constituents of the plate as well as measurable changes in thickness of the plate and length of the cartilage columns. These changes are relatively uniform and nearly independent of the kind of fracture and its treatment. Growth stimulation by fracture alone is moderate, limited to the time of fracture healing and hardly influenced by implantation of metallic material for osteosynthesis. 2. Angular deformity stimulates the epiphyseal plate to spontaneous correction. This correction is mostly stimulated by the change of pressure caused by the muscular coat and only minimally by static load. Correction of angular deformity can only happen under simultaneous increase in longitudinal growth, as long as pressure in the plate is changed. If angular deformity does not lead to changes in pressure by muscular tension on the concavity of the fracture (e.g. recurvation of tibia, varus in supracondylar fracture of humerus, torsion deformity of long bones) no stimulation of the epiphyseal plate will occur. In these cases the increase of growth is insignificant.
在一项临床和实验研究中，已发现两个因素对儿童骨折后生长增加最为重要：1. 创伤会导致骨骺血液循环发生变化。氧张力的改变会引起生长板细胞和细胞间成分的形态计量学改变，以及生长板厚度和软骨柱长度的可测量变化。这些变化相对均匀，几乎与骨折类型及其治疗方式无关。仅骨折引起的生长刺激较为适度，仅限于骨折愈合期，且几乎不受用于骨固定的金属材料植入的影响。2. 角畸形会刺激骨骺板进行自发矫正。这种矫正主要由肌肉层引起的压力变化所刺激，而静态负荷的刺激作用极小。只要生长板内压力发生变化，角畸形的矫正只能在纵向生长同时增加的情况下发生。如果角畸形不会因骨折凹陷处的肌肉张力而导致压力变化（例如胫骨后凸、肱骨髁上骨折内翻、长骨扭转畸形），则不会刺激骨骺板。在这些情况下，生长增加不明显。
