Ross T K, Zionts L E
Department of Orthopaedic Surgery, Orthopaedic Hospital, University of Southern California, Los Angeles, USA.
Clin Orthop Relat Res. 1997 Jul(340):236-43. doi: 10.1097/00003086-199707000-00031.
A rabbit model was used to compare the rate, efficacy, and histologic appearance of physeal growth inhibition effected by Phemister epiphysiodesis, epiphyseal stapling, and percutaneous epiphysiodesis. Each technique led to an effective physeal closure, although the Phemister and staple methods produced more rapid deceleration of growth. A slower rate of physeal closure was seen after percutaneous epiphysiodesis, because this technique produced a gap in the bone that initially filled with fibrous tissue before forming bridges of trabecular bone leading to closure of the growth plate. Elevation of the periosteum alone produced an initial growth stimulation followed by early physiologic physeal closure. The amount of physis to ablate when doing a percutaneous epiphysiodesis is controversial. These results suggest that a percutaneous technique with limited physeal ablation, as used in the current study, effects slower rate of growth inhibition than that by the Phemister and staple techniques. A percutaneous technique that ablates a larger portion of the physis may be desirable to obtain more rapid growth inhibition.
采用兔模型比较了菲米斯特骨骺阻滞术、骨骺钉固定术和经皮骨骺阻滞术对骨骺生长抑制的速度、效果和组织学表现。尽管菲米斯特法和钉固定法使生长减速更快，但每种技术均导致有效的骨骺闭合。经皮骨骺阻滞术后可见骨骺闭合速度较慢，因为该技术在骨内产生了一个间隙，该间隙最初充满纤维组织，之后形成小梁骨桥导致生长板闭合。单纯骨膜抬高最初会刺激生长，随后导致生理性骨骺早期闭合。进行经皮骨骺阻滞术时需切除的骨骺量存在争议。这些结果表明，如本研究中所用的有限骨骺切除的经皮技术，其生长抑制速度比菲米斯特法和钉固定法慢。可能需要一种能切除更大比例骨骺的经皮技术来获得更快的生长抑制。
