Abstract
Background: To develop a physeal slide-traction plate for children can provide rigid internal fixation of a bone fracture without inhibiting epiphyseal growth.
Methods: The slide-traction plates and standard plates were designed to configure to the femoral condyle. Twelve of thirty goats were used as normal controls and the rest were implanted with plates (right femurs were fixed with standard plates, and left femurs were fixed with slide-traction plates). All goats underwent X-ray examination at 1 month, 3 months and 6 months after surgery, and femoral length were measured. Histological staining and electron microscopy were performed to evaluate the development of the epiphyseal plate at 3 and 6 months after surgery.
Results: Compared to the standard plate, the slide-traction plate group exhibited more normal physeal growth, histologic features, safranin O staining, and electron microscopy structural features. There were significant differences in length in the femurs of goats fixed with slide-traction plates and standard plates at 1 month, 3 months, and 6 months after surgery, respectively. There was no difference between femurs of the normal control group and the femurs fixed with the slide-traction plates. Thicker epiphyseal plates were found in the left vs. the right femurs of the group fixed with plates at 3 and 6 months after surgery. In the group fixed with plates, Safranin O staining showed that the epiphyseal plates of the left femurs had more fuscous staining than the right femurs at 3 and 6 months after surgery. Electron microscopy also showed that cells in the epiphyseal plates of the left femurs were healthier in appearance than cells from the right femurs in the group fixed with plates.
Conclusion: The physeal slide-traction plate can slide with the growth of the physis and is suitable for fixation of fractures in this region.
Key words
physeal - slide-traction - plate - fracture fixation
References
-
1
Aronsson DD, Stokes IA, Rosovsky J. et al .
Mechanical modulation of calf tail vertebral growth: implications for scoliosis progression.
J Spinal Disord.
1999;
12
141-146
-
2
Bostman O, Makela EA, Sodergard J. et al .
Absorbable polyglycolide pins in internal fixation of fractures in children.
J Pediatr Orthop.
1993;
13
242-245
-
3
Flynn JM, Skaggs DL, Sponseller PD. et al .
The surgical management of pediatric fractures of the lower extremity.
Instr Course Lect.
2003;
52
647-659
-
4
Gomes LS, Volpon JB, Goncalves RP.
Traumatic separation of epiphyses. An experimental study in rats.
Clin Orthop Relat Res.
1988;
286-295
-
5
Greco F, de Palma L, Specchia N. et al .
Growth-plate cartilage metabolic response to mechanical stress.
J Pediatr Orthop.
1989;
9
520-524
-
6
Inoue T, Naito M, Fujii T. et al .
Partial physeal growth arrest treated by bridge resection and artificial dura substitute interposition.
J Pediatr Orthop B.
2006;
15
65-69
-
7
LeVeau BF, Bernhardt DB.
Developmental biomechanics. Effect of forces on the growth, development, and maintenance of the human body.
Phys Ther.
1984;
64
1874-1882
-
8
Ogden JA.
Injury to the growth mechanisms of the immature skeleton.
Skeletal Radiol.
1981;
6
237-253
-
9
Ogden JA.
The evaluation and treatment of partial physeal arrest.
J Bone Joint Surg Am.
1987;
69
1297-1302
-
10 Ogden JA. Skeletal Injury in the Child. New York: Springer-Verlag; 2000
-
11
Partio EK, Tuompo P, Hirvensalo E. et al .
Totally absorbable fixation in the treatment of fractures of the distal femoral epiphyses. A prospective clinical study.
Arch Orthop Trauma Surg.
1997;
116
213-216
-
12
Pihlajamaki H, Bostman O, Tynninen O. et al .
Long-term tissue response to bioabsorbable poly-L-lactide and metallic screws: an experimental study.
Bone.
2006;
39
932-937
-
13
Pihlajamaki H, Salminen S, Laitinen O. et al .
Tissue response to polyglycolide, polydioxanone, polylevolactide, and metallic pins in cancellous bone: An experimental study on rabbits.
J Orthop Res.
2006;
24
1597-1606
-
14
Radhakrishnan P, Lewis NT, Mao JJ.
Zone-specific micromechanical properties of the extracellular matrices of growth plate cartilage.
Ann Biomed Eng.
2004;
32
284-291
-
15
Sato T, Shinozaki T, Fukuda T. et al .
Atypical growth plate closure: a possible chronic Salter and Harris Type V injury.
J Pediatr Orthop B.
2002;
11
155-158
-
16
Stiefel D, Meuli M, Altermatt S.
Fractures of the neck of the radius in children. Early experience with intramedullary pinning.
J Bone Joint Surg Br.
2001;
83
536-541
-
17
Trebicz-Geffen M, Nevo Z, Evron Z. et al .
The short-lived exostosis induced surgically versus the lasting genetic hereditary multiple exostoses.
Exp Mol Pathol.
2003;
74
40-48
Correspondence
Dr. J. Y. Hong
Orthopaedic Trauma
Center of PLA
Department of Orthopedic
363000 Zhangzhou
China
Phone: +86 13605082196
Fax: +86 596 2931538
Email: hongjy175@yahoo.com.cn
