Surgical treatment of partial closure of the growth plate

During the period from 1965 to 1980, 43 operations for partial closure of a growth plate were performed on 35 patients. Five of the operations were for recurrent partial closure. At operation, the bone bridge connecting epiphysis to metaphysis was removed and replaced with a free fat transplant as described by the author in 1967 and 1975. Of the operations, 18 were on the distal end of the femur and 13 on either end of the tibia. Closure was due to fracture in 28 growth plates and septic osteomyelitis in 8. Benefit from the procedure was questionable after 7 operations. All other operations resulted in restoration of growth and correction or prevention of deformity. The operation prevents deformation of the joint surface, an effect that cannot be achieved by osteotomy or leg lengthening. Deformity present before operation is often reduced by growth to a normal condition after the procedure. Age, location of the bone bridge, and its size influence the indication for the operation and its results. Free fat, as an interposition material, has some advantages compared to solid materials, which may require a second procedure for removal.