Janovec M, Jochymek J
Klinika dĕtské ortopedie LF Masarykovy univerzity, Brno.
Acta Chir Orthop Traumatol Cech. 1993;60(5):306-10.
The authors evaluated the state and behaviour of 18 growth cartilages in 16 patients lengthened by the method of distraction epiphysiolysis in 1974 to 1991 at the Clinic of Child Orthopaedics in Brno. Lengthening was performed in 8 boys and 8 girls in the area of the distal femur and/or proximal or distal tibia. The follow-up period of these patients was 2 to 8 years. The authors revealed that the bone age of the patient had a decisive effect on the state and behaviour of the lengthened epiphyseal growth plate. The mode and rate of release of the growth zone was the same, similarly as the rate of lengthening; despite this the patients could be divided into three defined groups: 1. The growth cartilage remained open, remained active and closed when the cartilages on the non-lengthened side closed. The bone age was on average 8 years. 2. The growth cartilage was apparent for a certain period (2 or more years) but closed sooner than on the non-lengthened side. The mean bone age was 10.35 years. 3. The growth cartilage disappeared already during distraction epiphysiolysis. The mean bone age was 14.3 years. The authors conclude that assessment of the bone age in patients where lengthening of bones by distraction epiphysiolysis is planned is very useful as it makes it possible to predict with a high probability further behaviour of the epiphyseal cartilage after its lengthening and thus the need of possible revision.
作者评估了1974年至1991年在布尔诺儿童骨科诊所采用骨骺牵伸延长术治疗的16例患者中18块生长软骨的状态和行为。对8名男孩和8名女孩的股骨远端和/或胫骨近端或远端进行了延长手术。这些患者的随访期为2至8年。作者发现,患者的骨龄对延长后的骨骺生长板的状态和行为具有决定性影响。生长区的释放方式和速率与延长速率相同;尽管如此,患者仍可分为三个明确的组:1. 生长软骨保持开放,保持活跃,并在未延长侧的软骨闭合时闭合。平均骨龄为8岁。2. 生长软骨在一定时期(2年或更长时间)内可见,但比未延长侧闭合得更早。平均骨龄为10.35岁。3. 生长软骨在骨骺牵伸延长术期间就已消失。平均骨龄为14.3岁。作者得出结论,对于计划采用骨骺牵伸延长术延长骨骼的患者,评估骨龄非常有用,因为它可以大概率预测延长后骨骺软骨的进一步行为,从而预测是否需要进行可能的翻修手术。