Top

Archives of Orthopaedic and Trauma Surgery

Published in:

01-08-2007 | Orthopaedic Surgery

The influence of callus distraction on the growth plate

Authors: Bernd Fink, Kay Ostermeyer, Joachim Singer, Michael Hahn, Martin Sager, Alfred Enderle, Günter Delling

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 6/2007

Abstract

Objectives

This study was designed to investigate the morphology, thickness and cellularity of the growth plate during callus distraction performed in the immediate vicinity of the growth plate.

Methods

Lengthening of the right tibia by 25% was carried out on 24 beagle dogs by callus distraction. Distraction was started at the fifth postoperative day with a distraction rate of 0.5 mm twice a day. A control group of six dogs underwent tibial osteotomy and external fixation without distraction. Half of the dogs of both groups were sacrificed at the end of the distraction phase of 25 days (Group A) and the remaining 15 dogs after an additional consolidation period of 25 days (Group B). The tibia and femur was removed from the distracted right leg and from the left control side of each animal and longitudinal sections were cut and stained with Pentachrome. The thickness and cellularity of the regeneration zone, the proliferation zone and the hypertrophic zone were determined for the proximal tibial and the distal femoral epiphysis.

Results

During the distraction phase the thickness of the proximal tibial growth plate and its cellularity were reduced on the distraction side. During the consolidation phase there was a slight recovery in the proximal tibial growth plate.

Conclusions

Callus distraction leads to a temporary reduction in growth of the affected physis.

Anderson M, Gree WT, Messner MB (1963) Growth and predictions of growth in the lower extremities. J Bone Joint Surg 54-A:1–14

Aronson J, Good B, Steward CL, Harp JH (1990) Preliminary studies of mineralisation during distraction osteogenesis. Clin Orthop 250:42–49

Cattaneo R, Villa A, Catagni M, Tentori L (1988) Limb lengthening in achondroplasia by Ilizarov’s method. Int Orthop 12:173–179PubMedCrossRef

Chen MM, Jee WS, Ke HZ, Lin BY, Li QN, Li XJ (1992) Adaptation of cancellous bone to aging and immobilization in growing rats. Anat Rec 234:317–334PubMedCrossRef

De Bastiani G, Algegheri R, Renzi Brivio L, Trivella G (1986) Limb lengthening by distraction of the epiphyseal plate. A comparison of two techniques in the rabbit. J Bone Joint Surg 68-B:545–549

De Pablos J Jr, Canadell J (1990) Experimental physeal distraction in immature sheep. Clin Orthop 250:73–80PubMed

De Pablos J Jr, Barrios C, Alfaro C, Canadell J (1994) Large experimental segmental bone defects treated by bone transportation with monolateral external distractors. Clin Orthop 298:258–265

Fink B, Krieger M, Strauss JM, Opheys C, Fischer J (1995) Osteoneogenesis by callus distraction and distraction epiphysiolysis. Z Orthop 133:501–506PubMedCrossRef

Fink B, Krieger M, Strauss JM, Opheys C, Menkhaus S, Fischer J, Rüther W (1996) Osteoneogenesis and its influencing factors during treatment with the Ilizarov method. Clin Orthop 323:261–272PubMedCrossRef

10.

Fink B (1999) The behaviour of the soft-tissues during leg lengthening. Orthopäde 28:1007–1014PubMed

11.

Fink B, Braunstein S, Singer J, Schmielau G, Rüther W (1999) The behaviour of tendons during lower-leg lengthening in dogs using the Ilizarov method. J Pediatr Orthop 19:380–385PubMedCrossRef

12.

Fink B, Schwinger G, Singer J, Schmielau G, Rüther W (1999) Biomechanical properties of tendons during lower-leg lengthening in dogs using the Ilizarov-method. J Biomech 32:763–768PubMedCrossRef

13.

Fink B, Neuen-Jacob E, Lienert A, Francke A, Niggemeyer O, Rüther W (2001) Changes in canine skeletal muscles during experimental tibial lengthening. Clin Orthop 385:207–218PubMedCrossRef

14.

Fishbane BM, Riley LH Jr (1978) Continuous transphyseal traction: experimental observations. Clin Orthop 136:120–124PubMed

15.

Frost HM (1979) A chondral modeling theory. Calcif Tissue Int 28:181–200PubMedCrossRef

16.

Giebel G (1993) Kallusdistraktion. Thieme-Verlag, Stuttgart

17.

Hamanishi C, Tanaka S, Tamura K (1992) Early physeal closure after femoral chondrodiatasis. Loss of length gain in 5 cases. Acta Orthop Scand 63:146–149PubMedCrossRef

18.

Hankemeier S, Bastian L, Gosling T, Krettek C (2004) Principle of callus distraction. Unfallchirurg 107:945–958PubMedCrossRef

19.

Hunziker EB, Schenk RK, Cruz-Orive LM (1987) Quantitation of chondrocyte performance in growth-plate cartilage during longitudinal bone growth. J Bone Joint Surg 69-A:162–173

20.

Ilizarov GA (1990) Clinical application of the tension-stress effect for limb lengthening. Clin Orthop 250:8–26PubMed

21.

Ilizarov GA (1992) Transosseous osteosynthesis. Springer, Heidelberg

22.

Kenwright J, Spriggins AJ, Cunningham JL (1990) Response of the growth plate to distraction close to skeletal maturity. Is fracture necessary? Clin Orthop 250:61–72PubMed

23.

Montufar-Solis D, Duke PJ, Durnova G (1992) Spaceflight and age affect tibial epiphysial growth plate histomorphometry. J Appl Physiol 73:19S–25SPubMed

24.

Nuttall JD, Brumfield LK, Fazzalari NL, Hopwood JJ, Byers S (1999) Histomorphometric analysis of the tibial growth plate in a feline model of Mucopolysaccharidosis Tyoe VI. Calcif Tissue Int 65:47–52PubMedCrossRef

25.

Olney BW, Jayaraman G (1994) Joint reaction forces during femoral lengthening. Clin Orthop 301:64–67PubMed

26.

Orbay JL, Frankel VH, Finkle JE, Kummer FJ (1992) Canine leg lengthening by the Ilizarov Technique. A biochemical, radiologic, and morphologic study. Clin Orthop 278:265–273PubMed

27.

Paley D (1988) Current techniques of limb lengthening. J Pediatr Orthop 8:73–92PubMed

28.

Pfeil J (1994) Technik der unilateralen Kallusdistraktion an Femur und Tibia. Operat Orthop Traumatol 6:1–28CrossRef

29.

Price CT (1989) Metaphyseal and physeal lengthening. Instr Course Lect 38:331–336PubMed

30.

Rajacich NN, Bell DF, Armstrong PF (1992) Pediatric applications of the Ilizarov method. Clin Orthop 280:72–80PubMed

31.

Rheinholt FP, Hjerpe A, Jansson K, Engfeldt B (1984) Stereological studies on the epiphyseal growth plate in low phosphate, vitamin D-deficiency rickets with special reference to the distribution of matrix vesicles. Calcif Tissue Int 36:95–101CrossRef

32.

Rheinholt FP, Hjerpe A, Jansson K, Engfeldt B (1984) Stereological studies on the epiphyseal growth plate in strontium-induced rickets with special reference to the distribution of matrix vesicles. J Bone Joint Surg 66-A:1274–1280

33.

Rommeis B (1989) Modifizierte Movat-Pentachromfärbung. In: Böck P (ed) Mikroskopische Technik. Verlag Urban und Fischer, Stuttgart, pp 558–559

34.

Schenk RK, Olah AJ (1980) Histomorphometrie. Handbuch der Inneren Medizin Springer, Berlin, pp 437–494

35.

Smeets T, van Buul-Offers S (1983) A morphological study of the development of the tibial proximal epiphysis and growth plate of normal and dwarfed Snell mice. Growth 47:145–149PubMed

36.

Spriggins AJ, Bader DL, Cunningham JL, Kenwright J (1989) Distraction physiolysis in the rabbit. Acta Orthop Scand 60:154–158PubMedCrossRef

37.

Thorp BH (1988) Relationship between the rate of longitudinal bone growth and physeal thickness in the growing fowl. Res Vet Sci 45:83–85PubMed

38.

Wada A, Fujii T, Takamura K, Yanagida H, Urano N, Yamaguchi T (2006) Limb salvage treatment for congenital deficiency of the tibia. J Pediatr Orthop 26:226–232PubMed

39.

Welch RD, Birch JJG, Makarov MR, Samchukoc ML (1998) Histomorphometry of distraction osteogenesis in a caprine tibial lengthening model. J Bone Miner Res 13:1–9PubMedCrossRef

40.

Zarzycki D, Tesiorowski M, Zarzycka M, Kacki W, Jasiewicz B (2002) Long-term results of lower limb lengthening by physeal distraction. J Pediatr Orthop 22:367–370PubMedCrossRef

Title: The influence of callus distraction on the growth plate
Authors: Bernd Fink
Kay Ostermeyer
Joachim Singer
Michael Hahn
Martin Sager
Alfred Enderle
Günter Delling
Publication date: 01-08-2007
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 6/2007
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-007-0371-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The influence of callus distraction on the growth plate

Abstract

Objectives

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 6/2007

Calcaneal insufficiency fracture in a child with osteosarcoma after chemotherapy and limb-sparing surgery

Improvement of the long-term adhesive strength between bone cement and bone in cemented cup arthroplasty: ex-vivo study

Compartment syndrome in the hand due to extravasation of contrast material

Displaced proximal humeral fractures: intramedullary nailing versus conservative treatment

Interruption of the blood supply of femoral head: an experimental study on the pathogenesis of Legg-Calve-Perthes Disease

Mechanical torque measurement predicts load to implant cut-out: a biomechanical study investigating DHS® anchorage in femoral heads