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Bone growth after replantation in children
E Demiri1, J Bakhach, N Tsakoniatis
1Department of Plastic, Reconstructive, Hand Surgery, and Microsurgery, Hôpital du Tondu, Bordeaux, France.
Journal of Reconstructive Microsurgery
|March 1, 1995
Summary
Pediatric limb replantation generally preserves skeletal growth, with replanted parts achieving over 90% of expected bone growth. Amputation level significantly influences the prognosis for epiphyseal plate growth in children.
Area of Science:
- Pediatric Orthopedics
- Regenerative Medicine
- Traumatology
Background:
- Replantation of pediatric amputated extremities can disrupt bone growth and epiphyseal plate development.
- Assessing long-term skeletal growth potential after replantation is crucial for functional recovery.
Observation:
- This study evaluated 13 upper limb replantations in 12 children under 15 years old.
- Long-term follow-up (21-216 months) assessed bone growth in proximal and distal segments.
- Two distinct growing segments were analyzed: the traumatically injured proximal bone and the distal replanted portion.
Findings:
- Replanted parts demonstrated substantial longitudinal bone growth, averaging 94.5% (proximal) and 92.7% (distal) of expected growth.
- Two patients experienced proximal bone overgrowth (110% and 118% of expected).
- The level of amputation emerged as a significant prognostic factor for epiphyseal growth in replanted segments.
Implications:
- Pediatric limb replantation offers a high potential for maintained skeletal growth, even with initial growth disturbances.
- Understanding prognostic factors like amputation level can optimize surgical planning and patient outcomes.
- Further research is needed to fully elucidate all factors influencing post-traumatic epiphyseal plate reactions.