Ippolito E, Mickelson M R, Ponseti I V
J Bone Joint Surg Am. 1981 Sep;63(7):1109-13.
Core biopsies of the proximal femoral growth plate from three patients with slipped capital femoral epiphysis were compared with three normal growth plates from patients of similar ages. The growth plates of patients with slipped capital femoral epiphysis had a normal resting zone, a loose and fibrillated proliferative zone, and a very disarranged and thickened hypertrophic zone. The proliferative zone stained strongly with alcian blue, suggesting the presence of abundant proteoglycans in the cartilage matrix. The thickened hypertrophic zone was strongly positive to periodic acid-Schiff stain, indicating the presence of abundant structural glycoproteins. Enchondral ossification was scanty and irregular, and there were large clusters of cartilage in the metaphysis. Slippage occurred through the thickened proliferative and hypertrophic zones.
The proximal femoral growth plate in slipped capital femoral epiphysis is histochemically abnormal and histologically disarranged. These features contribute to abnormal widening of the growth plate and to further slippage.
对3例股骨头骨骺滑脱患者的股骨近端生长板进行核心活检,并与3例年龄相仿患者的正常生长板进行比较。股骨头骨骺滑脱患者的生长板有正常的静止区、疏松且呈纤维状的增殖区以及排列非常紊乱且增厚的肥大区。增殖区经阿尔辛蓝染色呈强阳性,提示软骨基质中存在丰富的蛋白聚糖。增厚的肥大区对高碘酸 - 希夫染色呈强阳性,表明存在丰富的结构糖蛋白。软骨内成骨稀少且不规则,干骺端有大量软骨簇。滑脱通过增厚的增殖区和肥大区发生。
股骨头骨骺滑脱时股骨近端生长板在组织化学上异常,组织学上排列紊乱。这些特征导致生长板异常增宽并进一步滑脱。