Abstract
In Clinical practice damage to the growth plate is usually caused by trauma. In neonates and infants, sepsis involving the growth plate may lead to very severe deformities as well as limb length discrepancy. The management for the child with physeal growth arrest depends on the age of the child, the site and the extent of involvement of the physis. The assessment of the extent of involvement of the physis can be made by plain x-rays, tomograms and magnetic resonance imaging. In younger children epiphysiolysis with or without an osteotomy is usually performed. In cases where is there is severe limb length discrepancy additional treatment with limb lengthening is carried out. Children towards the end of growth benefit from a corrective osteotomy. Hemichondrodiatasis is not recommended in younger children as there is a risk of physeal fracture leading to further growth arrest. However it can be used for selected cases towards the end of growth.
Epiphysiolysis with the use of interposition materials such as fat, silastic or cement has been shown to be successful for bony bars occupying less than 30 % of the entire physis. In cases where the physeal injury is more extensive recent experimental work has shown that the use of tissue engineering techniques involving the transfer of cultured chondrocytes or mesenchymal stem cells may produce better results than conventional methods.
The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.
