Lower Femoral Epiphysis Research Articles

Anomalies of ossification in the posterolateral femoral condyle: assessment by MRI

Anomalies of ossification in the lower femoral epiphysis are often radiographically indistinguishable from juvenile osteochondritis dissecans. To clarify the MRI characteristics of the anomalies of ossification in the posterolateral femoral condyle that distinguish it from juvenile osteochondritis dissecans. We retrospectively examined the medical records, plain radiographs (n = 4), MRI (n = 4) and follow-up MRI (n = 2) of four boys (age 8-11 years) with anomalies of ossification in the posterolateral femoral condyle. Plain radiography showed symmetrical marginal irregularity of the posterolateral femoral condyles of both knees. These lesions were asymptomatic, and the areas of irregular radiographic appearances reduced in size or disappeared without treatment within a mean observation period of 3.5 months. MRI showed a clearly demarcated low-intensity islet with the same signal intensity as subchondral bone (which was considered to be an accessory ossification nucleus) in a high-signal area in which the signal intensity was equal to that of normal articular cartilage. The areas observed as radiolucent zones on plain radiography were visualised at the same signal intensity as articular cartilage, and were continuous with articular cartilage on MRI; thus they were regarded as uncalcified cartilage. These MR findings are different from MR images of osteochondritis dissecans. MRI is considered to be the most effective non-invasive diagnostic method for these two conditions.

Fractures and Epiphyseal Deformities in Beta-Thalassemia

Sixty-two patients with beta-thalassemia (36 men and 26 women) were investigated in a survey of the incidence and distribution of fractures. Patient ages ranged from 10 to 32 years (mean, 16.7). The examination consisted of a detailed orthopedic and roentgenographic skeletal survey. Fractures are a frequent occurrence in beta-thalassemia (Cooley's anemia). One in three patients had sustained fractures. In one of five, fractures were multiple or recurrent. The fractures, however, were not entirely responsible for the high incidence of deformities. Only one patient had a malunited limb-deforming fracture. The high incidence of deformities was caused by the premature fusion of the epiphyses of the long bones; the pathogenesis of beta-thalassemia-induced epiphyseal fusion is obscure. Thirty patients of the 62 patients developed epiphyseal abnormalities, generally in the lower tibial and fibular, upper humeral, and lower femoral epiphyses. The ensuring deformities are severe and frequently occur in patients older than 12.

Tibial dysplasia. A study of the anatomy.

Three amputated legs with tibial dysplasia were studied by radiography, arteriography and anatomical dissection. The radiographic appearances were the same as the Type 1b tibial dysplasia described by Jones, Barnes and Lloyd-Roberts (1978) in that the tibiae were absent but the lower femoral epiphyses were normal. However, our anatomical findings differed from those of Jones et al. since no bony or cartilaginous anlage of the proximal tibia was found in any of the three legs. The pattern of vascular anomaly was identical in the three legs and similar to the findings of Hootnick et al. (1980) in congenital short fibula. Congenital fusion of the subtalar joint was a constant finding. These results support the hypothesis that the arterial and skeletal systems are vulnerable to a teratogenic insult in the fifth week of embryonic life. The bony and arterial anomalies should be borne in mind by the surgeon attempting reconstructive surgery for this condition.

Fractionation of the glycosaminoglycans of human articular cartilage on ecteola cellulose in ageing and in osteoarthrosis.

Articular cartilage from the lower femoral epiphysis of human autopsy cases was collected in ten age groups from birth to 95 years and in osteoarthrosis of two grades of severity. By chromatography on Ecteola cellulose columns, the different glycosaminoglycans were separated and keratan sulphate was fractionated. The results are consistent with earlier studies using CPC-cellulose column technique, i.e. a higher content of total hexosamine and chondroitin sulphate was found in early childhood. Furthermore, normal articular cartilage in adults showed a higher content and a higher degree of heterogeneity of keratan sulphate than in childhood. In osteoarthrosis, a decreased content of total hexosamine due to a decrease both of chondroitin sulphate and keratan sulphate was found.

CORRECTION OF LEG LENGTH DISCREPANCY BY EPLPHYSIAL ARREST

1. A simple calculation for the timing of epiphysial arrest to correct leg length discrepancy is described. An assumption is made that growth ceases at a constant chronological age of sixteen years in boys and fourteen years in girls. It is further assumed that the lower femoral epiphysis provides three-eighths of an inch and the upper tibial epiphysis one-quarter inch of growth each year. 2. Whilst the assumptions made are known to be approximations, analysis of the results of fifty-three epiphysial arrests in forty-four children shows that the errors cancel themselves sufficiently to make this method accurate. The simplicity of the calculation makes it useful to confirm or modify the timing of arrests calculated on the basis of skeletal age, or as an alternative method.

A Study of Experimental Trauma and Attempts to Stimulate Growth of the Lower Femoral Epiphysis in Rabbits—III

The placing of small nails of several different metals through the lower femoral epiphysis and across the epiphyseal cartilage of rabbits, both in the center and at the periphery of the plate, resulted in minor variations in length of the growing bone. In this small series of experiments slight retardation occurred more often than did slight stimulation, and in some animals neither occurred. The placing of two different metals through the lower femoral epiphysis and across the epiphyseal plate resulted in slight stimulation of growth of the femur in only two of ten rabbits. From these experiments it would appear that the placing of a metallic nail through the epiphysis of a long bone neither appreciably retards nor stimulates growth of the femur in the rabbit.

“Slipped” Lower Femoral Epiphysis in a Case of Eunuchoid Gigantism

“Slipped” Lower Femoral Epiphysis in a Case of Eunuchoid Gigantism

Report of Eighteen Cases of Separation of the Lower Femoral Epiphysis at the Boston City Hospital

Report of Eighteen Cases of Separation of the Lower Femoral Epiphysis at the Boston City Hospital