Desepiphysiodesis and Reconstruction of the Distal Radial Growth Plate with an Autologous Iliac Crest Cartilage Graft: A Case Report and Review of Literature.

Abstract

The term "desepiphysiodesis" consists of removing a partial premature epiphyseal closure due to the formation of an osseous bridge and replacing it by interpositional inert material; in spite of the experimental evidence supporting the efficacy of autologous cartilage as interposition material into resection cavity to permit the remaining growth, this option, curiously, is not found in clinical practice and literature. Indeed, surgical treatment for partial growth injury, autogenous, fat, and non-biological grafts is most frequently transplanted after physeal bar resection to prevent and/or correct angular deformities. This is a case report of a 10-year-old boy with an angular defect of the right distal radial growth plate which was the result of a post-traumatic lesion. The bone bridge was resected and replaced with an autologous block from the apophyseal cartilage of iliac crest. We are aware of this is the second case reported, in which autologous physeal graft was successfully used, observing a satisfactory long-term evolution of the patient. This research shows that the treatment of growth arrest with autologous iliac crest apophyseal cartilage graft is an effective method that can yield excellent results.