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Review
. 2018 Mar;9(Suppl 1):S58-S66.
doi: 10.1016/j.jcot.2018.01.001. Epub 2018 Jan 6.

Management of growth arrest: Current practice and future directions

Sherif Dabash  1 , Gautham Prabhakar  2 , Eric Potter  2 , Ahmed M Thabet  2 , Amr Abdelgawad  2 , Stephen Heinrich  3
Affiliations
Review

Management of growth arrest: Current practice and future directions

Sherif Dabash et al. J Clin Orthop Trauma. 2018 Mar.

Abstract

Introduction: Premature growth arrest can pose a challenge to the orthopedic surgeon. Various options for treating physeal arrest exist.

Methods: Systematic searches were conducted on PubMed/Medline, ScienceDirect, OVID, and Cochrane Library. Secondary searching was performed, where certain articles from reference lists of the selected studies were reviewed that were not found in the primary search.

Results: This review article discusses the different methods of management for premature growth arrest.

Conclusions: The use of mesenchymal stem cells provides a promising alternative treatment modality.

Keywords: Chondrodiastasis; Deformity correction; Epiphysiodesis; Growth arrest; Physeal bar; Physeal injuries.

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Figures

Fig. 1
Fig. 1
Salter Harris classification.
Fig. 2
Fig. 2
Physeal injury type1 (extension through the hypertrophic zone of the physis).
Fig. 3
Fig. 3
Peanut Plate of Biomet.
Fig. 4
Fig. 4
A: AP and Lateral x-rays of the original injury (fracture midshaft femur). B: Knee valgus and recurvatum 3 years after the initial injury. C: Yellow arrow represents the closure of the anterior tibial physis. The posterior proximal tibial angle on the affected RT side is 117. D: Red arrow represents the anterior tibial physis still intact on the unaffected side. The posterior proximal tibial angle on the unaffected side is 81. E: High tibial osteotomy with application of TSF. F: AP and Lateral 3 months postoperative x-rays showing the gradual correction of the deformity. G: AP and Lateral 6 months postoperative x-rays showing the final correction of the deformity with removal of the TSF and application of a cast.
Fig. 4
Fig. 4
A: AP and Lateral x-rays of the original injury (fracture midshaft femur). B: Knee valgus and recurvatum 3 years after the initial injury. C: Yellow arrow represents the closure of the anterior tibial physis. The posterior proximal tibial angle on the affected RT side is 117. D: Red arrow represents the anterior tibial physis still intact on the unaffected side. The posterior proximal tibial angle on the unaffected side is 81. E: High tibial osteotomy with application of TSF. F: AP and Lateral 3 months postoperative x-rays showing the gradual correction of the deformity. G: AP and Lateral 6 months postoperative x-rays showing the final correction of the deformity with removal of the TSF and application of a cast.
Fig. 5
Fig. 5
A: AP, Oblique, and Lat x-rays of the hand and wrist joint showing ulnar shortening due to physeal injury. B: Osteotomy with application of uni planar external fixator to correct the shortening. C: Anteroposterior and lateral radiographs demonstrating lengthening of the ulna with consolidation of the regenerate.
See this image and copyright information in PMC

References

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