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KMID : 0350519950480030825
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Journal of Catholic Medical College
1995 Volume.48 No. 3 p.825 ~ p.834
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The Effect of Epiphyseal Stapling on Long Bone Growth Plate
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Abstract
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The growth plate, or physis, is the essential structure of endochondral ossification. Interstitial growth of chondrocyte within the epiphyseal plate account for longitudinal growth of the shaft of a long bone.
The factors affecting cell division within the hysis are not completely umderstood. According to the Hueter-Volkmann's law, there is no doubt that growth may be arrested by epiphyseal stapline.
This study was performed to clarify the histological changes of the growth plate according to the duration of mechanical holding of growth plate by epiphyseal stapling method, the optimal time of staple removal for expectine the growth potential
on
stapling site, and histological change of the growth plate after removal of staples. Eighteen experimental rabbits (2-3 months old) were divided into three groups. Two staples were inserted extraperiosteally into medial aspect of right proximal
tibial
growth plate in experimental rabbits. Staples were removed at 4 wks after epiphyseal stapling in groupⅠ, at 6 wks in groupⅡ, and at 8 wks in groupⅢ. Experimental animals were sacrificed at 4 wks and 8 wks after staple romoval opcration, and
histological studies were made. Left tibias were used for specimens.
@ES The results were as follows :
@EN 1. Varus angulation deformity was developed at the proximal tibia as a result of medial proximal tibial epiphyseal stapling.
2. Increased cellularity in the zone of provisional calcification, generalized decrease in cellularity of the growth plate, distortion of columnar arrangement, and thinning of the growth plate were observed in groupⅠ&Ⅱand these findings were
more
prominent in groupⅡthan in groupⅠ. In groupⅢ, in addition to the findings observed in groupⅠ&Ⅱ, loss of columnar arrangement and ossification of the zone of provisional calcification were also observed.
3. In case of mechanical retardation of growth using epiphyseal stapling, functional recovery of growth plate was observed after removal of staples when the duration of epiphyseal stapling was for 4-6 wks, more than this, irreversible changes
were
developed.
From this study, it is demonstrated that beyond physiologic limit of compression by epiphyseal stapling method, growth may be signficanly decreased or even stopped. Regaining of growth after removal of staple is not possible under long duration
of
excessive compression, but functional recovery of growth plate is possible when staples are removed in an optimal time.
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