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Related Experiment Videos

The longitudinal epiphyseal bracket: implications for surgical correction.

T R Light, J A Ogden

    Journal of Pediatric Orthopedics
    |January 1, 1981
    PubMed
    Summary

    Skeletal deformities in children require understanding unique bone anatomy. A "longitudinal epiphyseal bracket" deformity necessitates fat interposition, not bone grafts, after osteotomy to prevent growth issues.

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    Radiology of bone diseases.

    Orthopedics·2014

    Area of Science:

    • Orthopedic surgery
    • Pediatric orthopedics
    • Skeletal anatomy

    Background:

    • Surgical correction of pediatric hand and foot deformities demands precise understanding of evolving chondro-osseous anatomy.
    • Abnormalities in skeletally immature patients present unique challenges due to the presence of physes (growth plates).

    Observation:

    • Detailed examination revealed a trapezoid-shaped metatarsal osseous unit with a functioning physis and epiphysis on the lateral side.
    • The periosteum was normal only on the medial side of the diaphysis.
    • An arcuate physis extended medially, laterally, and back medially, with a composite epiphyseal ossification center.

    Findings:

    • The described anatomical anomaly was termed a "longitudinal epiphyseal bracket."
    • Routine use of bone grafts with opening wedge chondro-osteotomy in these cases may lead to partial surgical epiphyseodesis.

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  • This can result in recurrent angular deformity or cessation of longitudinal bone growth.

    • Implications:

    • For skeletally immature patients with this deformity, osteotomy with fat interposition is recommended over bone grafting.
    • This approach aims to avoid complications like growth arrest and recurrent deformities.
    • Findings suggest a modified surgical technique for treating specific pediatric foot and hand deformities.