Top

Published in:

01-12-2013 | Current Concept Review

Longitudinal epiphyseal bracket

Authors: Alexander D. Choo, Scott J. Mubarak

Published in: Journal of Children's Orthopaedics | Issue 6/2013

Abstract

Longitudinal epiphyseal bracket or bracket epiphysis is an uncommon disorder of growth. Alternatively known as a delta phalanx, it is due to an anomalous secondary ossification center that extends longitudinally along the diaphysis. Although rare, longitudinal epiphyseal bracket most commonly manifests in the hands as clinodactyly and in the feet as hallux varus. Previously, longitudinal epiphyseal bracket has been treated with angular osteotomy, but we recommend early surgical physiolysis. We describe this uncommon disorder, our current recommendation for treatment, and present three illustrative cases.

Burnstein MI, De Smet AA, Breed AL, Thomas JR, Hafez GR (1989) Longitudinal tibial epiphyseal bracket in Nievergelt syndrome. Skeletal Radiol 18:121–125CrossRef

Elliott AM, Evans JA, Chudley AE, Reed MH (2004) The duplicated longitudinal epiphysis or “kissing delta phalanx”: evolution and variation in three different disorders. Skeletal Radiol 33:345–351CrossRef

Jones GB (1964) Delta phalanx. J Bone Joint Surg Br 46:226–228

Jaeger M, Refior HJ (1971) The congenital triangular deformity of the tubular bones of hand and foot. Clin Orthop Relat Res 81:139–150CrossRef

Carstam N, Theander G (1975) Surgical treatment of clinodactyly caused by longitudinally bracketed diaphysis (“delta phalanx”). Scand J Plast Reconstr Surg 9:199–202CrossRef

Watson HK, Boyes JH (1967) Congenital angular deformity of the digits. Delta phalanx. J Bone Joint Surg Am 49:333–338

Light TR, Ogden JA (1981) The longitudinal epiphyseal bracket: implications for surgical correction. J Pediatr Orthop 1:299–305CrossRef

Vickers D (1987) Clinodactyly of the little finger: a simple operative technique for reversal of the growth abnormality. J Hand Surg Br 12:335–342CrossRef

Ogino T (1990) Cleft hand. Hand Clin 6:661–671

10.

Mubarak SJ, O’Brien TJ, Davids JR (1993) Metatarsal epiphyseal bracket: treatment by central physiolysis. J Pediatr Orthop 13:5–8CrossRef

11.

Shea KG, Mubarak SJ, Alamin T (2001) Preossified longitudinal epiphyseal bracket of the foot: treatment by partial bracket excision before ossification. J Pediatr Orthop 21:360–365

12.

Olason AT, Döhler JR (1988) Delta formation in foot polydactyly. Arch Orthop Trauma Surg 107:348–353CrossRef

13.

Johnson JM, Higgins TJ, Lemos D (2011) Appearance of the delta phalanx (longitudinally bracketed epiphysis) with MR imaging. Pediatr Radiol 41:394–396CrossRef

14.

Mahboubi S, Davidson R (1999) MR imaging in longitudinal epiphyseal bracket in children. Pediatr Radiol 29:259–261CrossRef

Title: Longitudinal epiphyseal bracket
Authors: Alexander D. Choo
Scott J. Mubarak
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: Journal of Children's Orthopaedics / Issue 6/2013
Print ISSN: 1863-2521
Electronic ISSN: 1863-2548
DOI: https://doi.org/10.1007/s11832-013-0544-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Longitudinal epiphyseal bracket

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2013

7th International Congress on Early Onset Scoliosis and Growing Spine (ICEOS), November 21–22, 2013, Rancho Bernardo, CA

Supracondylar osteotomy of the paediatric femur using the locking compression plate: a refined surgical technique

Radiological outcome and gait function of SCFE patients after growth arrest

The spectrum of musculoskeletal problems in lipomyelomeningocele

Pediatric supracondylar humerus fractures: effect of bone–implant interface conditions on fracture stability

Upcoming meetings and courses