Longitudinal epiphyseal growth after replantation and transplantation in children

Previous investigators have shown that epiphyses are unlikely to grow after free grafting although there have been rare reports of good and even normal growth. However, growth has usually continued whenever the epiphyseal vascular supply has been maintained by microanastomosis. Of 25 growing epiphyses in our series that were transferred, 17 by replantation and eight by free tissue transfer supported by microvascular anastomosis, over an interval varying from 27 to 81 months, average length attained was 89% of normal in elective transfer, 93% of normal in replanted digits, and 92% overall. Maximum growth attained in any digit in our series was 102% of the length of the normal contralateral digit; the minimum attained was 70%.