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KMID : 0371919900030010101
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Journal of Wonju College of Medicine
1990 Volume.3 No. 1 p.101 ~ p.106
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Abstract
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The growth plates for the femoral head and the greater trochanter are not separate but part of a continuous layer in the form of an inverted L shape with a short limb associated with the capital center and a longer limb for the upper border of the neck and greater trochanteric center.
The capital epiphyseal plate contributes significantly to metaphyseal growth in the neck of the femur and less to primary appositional growth of the femoral head.
Conversely, the trochanteric apophysis contributes significantly to appositional growth of the greater trochanter and to a lesser degree to the metaphyseal growth of the femur.
It is generally believed that the greater trochanteric plate is not responsible for longitudinal growth of the the femur. In order to determine the effect of longitudinal growth following injury to either the proximal femoral physis or trochanteric epiphysis, surgical procedures were performed on 6 week old New Zealand rabbits and dogs.
The first group was femur head including epiphyseal plate excision group in 2 rabbits and 2 dogs. The second group was greater trochanter including epiphyseal plate excision group in 2 rabbits and 2 dogs. The third group was both excision of greater trochanter and femoral head in 2 rabbits and 2 dogs. The last group was greater trochanyteric arthroplasty group after femoral head including epiphyseal plate excision in 2 rabbits and 2 dogs.
The results of study were as follows:
1. Excision of the Greator trochanter apophrsis does not affect the rate of growth of the proximal femoral physis but noted increased anteversion of upper femur end.
2. Trochanter apophyseal growth center contribute little to femoral growth, but it is possible in situations in which the proximal physis has been destroyed that the apophysis does contribute something to upper femoral length.
3. There appear to be little difference in activity between the two proximal growth centers. Both have equal growth potential.
4. Although there is some tensile force though the glutei, the epiphysis of greater trochanter is not purely responsive to tension, and also the cytoarchitecture is similar to that of the capital femoral physis.
5. Trochanteric arthroplasty should be seriously considered in the problems of progressive leg length inequality.
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