Experimental Study for the Effects of Free Physeal Transplantation to Regain Bone Grwoth after Partial Physeal Injury / 대한정형외과학회잡지

This study is performed to investigate whether free transplanted iliac physis can grow in the resected epiphyseal plate and prevent growth arrest secondary to an injury of epiphyseal plate. Growth arrest, angulation and regeneration of epiphyseal plate after free physeal transplantation from iliac crest in the partial resection of epiphyseal plate on the lateral aspect of the distal femoral epiphysis were analysed in process of time and compared with those of the simple partial resection of epiphyseal plate of distal femur. Seventy-six skeletally immature, three month-old rabbits with an initial weight of about 1200 to 1400gm were used for this study. The following experimental groups were made after partial resection of epiphyseal plate on lateral aspect of distal femoral epiphysis(2×7×3mm). Group A: partial resection alone(19 rabbits); Group B: muscle piece interposition(19 rabbits); Group C: free autogenous iliac crest physeal transplantation (38 rabbits). The opposite side of the leg was used as a control. Animals were killed and examined at the following time-intervals(14, 21, 30, 60 and 90 days after operation). The following results were obtained. 1. In the group of partial resections alone, the bone-brige formation between the femoral epiphysis and metaphysis revealed as early as 14 days, and this bridging was found consistently in all anlmals, which led to the growth arrest and valgus deformity. 2. In the group of muscle piece interpositions, the interposition materials were found temporarily effective for the prevention of epiphysiometaphyseal bone-bridge formation, but the effect was not significant to regain bone growth. 3. Histological studies showed that the grafted physis united with the residual part of the original femoral physis at 14 days after transplantation, and regained its columnar arrangement. The physeal graft appeared to be viable and contribute endochondral bone formation in following section (60, 90 days). 4. In the grodp of free autogenous iliaccrest physeal transplantations, the transplanted physis prevented or minimized the formation of a bone brige, growth arrest, and valgus deformity in most animals. Although not all of the physeal transplants were successful, physeal grafts would be most suceessful method regaining bone growth after focal injury of epiphyseal plate.

Anterversion of the Femoral Neck: Comparision of Methods of Measurement in Bone Model / 대한정형외과학회잡지

The significance of the angle of anteversion of the femur is widely recognised, especially incongenital dislocation of the hip, cerebral palsy, Legg-Calve-Perthes' disease, and in-toeing gait, And many methods of measuring the anteversion have been described since the early work by Drehmann (1909) who determined anteversion by fluoroscopy. But there has been no reliable method of measuring the angle until recently. The authors studied the comparative accuracy and reproducibility by the use of experimental model of femur on computerized tomography, axial technique(Dunn), biplanar method (Ryder-Crane) and fluoroscopic method(Rogers) and reported the results with consideration in clinical utility. 1. The most accurate and reproducible method is computerized tomography, but it has much clinical disadvantages such as uneconomic, limited supply, more time requiring in measuring, and also limited information until the ossification of the femoral head was not occur (below the 18 months of age). 2. The next accurate and reproducible method is fluoroscopic method and it is widely useful except the case of limited motion of hip joint. 3. The Ryder-Crane's biplanar method is very difficult in clincal use because of its poor accuracy and reproducibility, difficult mtasuring technique, limited in the situation of contracture, deformity around the hip. 4. The axial technique of Dunn are also useful in any state of hip joint and simplicity in its technique. 5. The more acceptable clinical slection of measuring the femoral anteversion are the combination of the above two or three methods and comparing it with the opposite hip.