Early Epiphyseal Closure Research Articles

Early Epiphyseal Fusion in Freiberg's Infraction

A case of Freiberg's Infraction of the third metatarsal which demonstrates early epiphyseal closure in this condition is presented. The etiology of this phenomenon is unclear.

For puberty that comes too soon, new treatment highly effective

Children with true precocious puberty can now be treated definitively with a potent, long-acting analogue of luteinizing hormone-releasing hormone (LHRH). The analogue not only arrests or reverses their premature sexual development but also slows their rapid growth and skeletal maturation, forestalling early epiphyseal closure. Hence, unlike untreated patients, the children probably can expect to attain normal adult stature. About 80 children currently are receiving once-daily subcutaneous injections (4 μg/kg of body weight) of the analogue on an investigational basis in a project of the National Institute of Child Health and Human Development (NICHD), Bethesda, Md. Of the children, who ranged in age from 9 months to 9 years at the start of the treatment, more than 90% have responded satisfactorily to the therapy. Approximately 30% have precocious puberty secondary to hypothalamic hamartomas. About 10% have entered puberty early because of other CNS abnormalities such as pineal tumors, endocrine conditions such

Five Cases of Familial Brachydactyly

Five cases of familial brachydactyly in two pedigrees are reported which include rare two cases with shortening of all metatarsals except the second bilaterally.In these instances was there painful callosity at both heads of the second metatarsals of normal length. Satisfactory results were obtained in both instances after operations.The deformities may result from the early epiphyseal closure since it was found only in affected metatarsals of a 11-year-old case.

Östrogentherapie bei Mädchen mit konstitutionellem Hochwuchs

Forty-one pubescent girls of constitutionally tall stature were given conjugated oestrogens for a continuous period averaging twenty-two months. Oral progestin was also given, daily for five days during the second half of each menstrual cycle. Average predicted height of the girls was 186.5 cm, average final height was only 179.2 cm. In half of the girls in whom treatment had been started before menarche the height reduction was 2 cm greater than in those started after menarche. There were no severe side effects. Extreme care should be taken to limit strictly the indications for this treatment. Only girls with a growth prognosis above 183 cm should be considered. Therapeutic overstimulation of the endometrium must be avoided. Earlier views that the cessation of growth under oestrogen is due to early epiphyseal closure have been shown to be wrong. Growth frequently ceases long before epiphyseal closure. Reduction of somatomedin production was found to be the cause. The average serum somatomedin level fell to 56.9% of basal concentration after six months' treatment. At the same time, the circadian profile of growth hormone indicated a threefold increase above basal level. This phenomenon probably reflects a negative feedback mechanism between growth hormone and somatomedin.

Pubertas Precox in A Six-Year-Old Boy Produced by a Tumor of the Testis, Probably of Interstitial Cell Origin

Gonadal hyperfunction may be divided into two general types, a), primary and b), secondary. There has been some doubt that such an entity as primary hypergonadism exists, provided the gonads are situated normally, especially with our newer knowledge of the essentiality of the anterior pituitary gonadotropic hormone or hormones for gonadal development and function. However, this conception does not take into consideration the possibility of tumors, interstitial cell or adrenocortical, the Secretions of which may have androgenic activity. Pubertas precox may be due to four known factors, a), anterior pituitary hyperfunction, b), pineal disturbance, c), certain adrenal cortex tumors or disturbances and d), interstitial cell tumor of the testis. There are frequent instances of precocious puberty produced by anterior pituitary gonadotropic hormones, especially in girls, as evidenced by secondary sexual development, early epiphyseal closure and onset of menstruation.

Effect of Treatment with Chorionic Gonadotropic Substance–A Report of 23 Cases

IN RECENT YEARS the use of chorionic gonadotropic substance in the treatment of various pathological conditions occurring in children has increased tremendously. This increase became especially marked when concentrated preparations began to be used for the treatment of cryptorchidism, gonadal hypoplasia, and genital hypoplasia. Since then many conflicting reports have been published relative not only to the efficacy of chorionic gonadotropic substance in these particular conditions, but also regarding the possible harmful effects of its use on bone growth especially in regard to early epiphyseal closure. Animal experimentation has indicated a definite relationship between the administration of active hormonal agents and growth of skeletal tissue. That such a direct relationship does exist has been recognized over a long period of time.