Abstract
Detailed examination of a complete chondro-osseous specimen from a patient with duplication of the first ray of the foot revealed the involved metatarsal had a trapezoid-shaped, diaphyseal-metaphyseal osseous unit that was longitudinally bracketed along the lateral side by a functioning physis, epiphysis, and secondary (epiphyseal) ossification center. The physis extended as an arc from the medial proximal side toward and along the lateral side and then back to the medial side distally. The medial side of the diaphysis had a normal periosteum. The longitudinal epiphyseal ossification bracket was a composite of initially separate proximal and distal secondary ossification centers that had progressively extended toward each other and finally coalesced along the laterally placed epiphyseal cartilage. We have termed this deformity the “longitudinal epiphyseal bracket” (LEB). The macroscopic and microscopic anatomy relevant to initial diagnosis and evaluation of sequential roentgenographic changes will be considered.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bucholz, R.W., Ogden, J.A.: Patterns of ischemic necrosis of the proximal femur in non-operatively treated congenital disease. In: The hip: Proceedings of the Hip Society, vol. 6. St. Louis: Mosby 1978
Burke, F., Flatt, A.: Clinodactyly. A review of a series of cases. The Hand 2, 269 (1979)
Carstam, N., Theander, G.: Surgical treatment of clinodactyly caused by longitudinally bracketed diaphysis (“delta phalanx”). Scand. J. Plast. Reconstr. Surg. 9, 199 (1975)
Cenani, A., Lenz, W.: Totale Syndaktylie und totale radioulnare Synostose bei zwei Brüdern. Z. Kinderheilk. 101, 181 (1967)
Cocchi, U.: Erbschäden mit Knochenveränderungen. In: Lehrbuch der Röntgendiagnostik, Shinz, H.R., Baensch, W.E., Friedl, E., Uehlinger, E. (eds.) Bd. 1. Stuttgart: Thieme 1952
Flatt, A.E.: The care of congenital hand anomalies. St. Louis: Mosby 1977
Fuerst, E.: Ein Fall von verkürzten und zweigliedrigen Fingern begleitet von Brustmuskeldefekten. Z. Morphol. Anthropol. 2, 17 (1900)
Haines, R.W.: The pseudoepiphysis of the first metacarpal in man. J. Anat. 117, 145 (1974)
Jaeger, M., Refior, H.J.: The congenital triangular deformity of the tubular bones of the hand and foot. Clin. Orthop., 81, 139 (1971)
Jones, G.B.: Delta phalanx. J. Bone Joint Surg. [Br] 46, 226 (1964)
Lenz, W.: Zur Diagnose und Ätiologie der Akrocephalo-Syndaktylie. Z. Kinderheilk. 79, 546 (1957)
Ogden, J.A.: Development and growth of the musculoskeletal system. In: The scientific basis of orthopaedics, Albright, J.A., Brand, R.A. (eds.). New York: Appleton-Century-Crofts 1979
Ogden, J.A., Vickers, T.H., Tauber, J.E., Light, T.R.: A model of ulnar dysmelia. Yale J. Biol. Med. 51, 193 (1978)
Ogden, J.A., Hempton, R.F., Southwick, W.O.: Development of the tibial tuberosity. Anat. Rec. 182, 431 (1975)
Ogden, J.A., Southwick, W.O.: Osgood-Schlatter's disease and development of the tibial tuberosity. Clin. Orthop. 116, 180 (1976)
Ogden, J.A., Conlogue, G.J., Jensen, P.S.: Radiology of postnatal skeletal development: The proximal humerus. Skeletal Radiol. 2, 153 (1978)
Ogden, J.A., Conlogue, G.J., Bronson, M.L., Jensen, P.S.: Radiology of postnatal skeletal development. II. The manubrium and sternum. Skeletal Radiol. 4, 189 (1979)
Ogden, J.A., Conlogue, G.J., Bronson, M.L.: Radiology of postnatal skeletal development. III. The clavicle. Skeletal Radiol. 4, 196 (1979)
Ogden, J.A.: Chondro-osseous Development and Growth. In: Fundamental and clinical bone physiology, Urist, M. (ed.). Philadelphia: Lippincott 1980
Ogden, J.A., Conlogue, G.J.: Developmental morphology of the cetacean flipper (carpus and manus). Study in progress.
Rhodes, R.K., Elmer, W.A.: Aberrant metabolism of matrix components in neonatal fibular cartilage of brachypod (bpH) mice. Develop. Biol. 46, 14 (1975)
Schatzki, P.: Über verdeckte syndaktyle Polydaktylie und über “Triangelbildung” in der menschlichen Hand. Arch. Orthop. Unfallchir. 34, 637 (1934)
Schoenenberg, H.: Mißbildung der Gliedmaßen — Extremitätenfehlbildungen. In: Handbuch der Kinderheilkunde, Opitz, H., schmid, F. (eds.), Bd. VI. Berlin: Springer 1967
Stover, C.N., Hayos, J.T., Holt, J.F.: Diastrophic dwarfism. Am. J. Roentgenol. 89, 914 (1963)
Taybi, H.: Diastrophic dwarfism. Radiology 80, 1 (1963)
Theander, G., Carstam, N.: Longitudinally bracketed diaphysis. Ann. Radiol. (Paris) 17, 355 (1974)
Watson, H.K., Boyes, J.H.: Congenital angular deformity of the digits. J. Bone Joint Surg. [Am] 49, 333 (1967)
Werthemann, A.: Die Entwicklungsstörungen der Extremitäten. In: Handbuch der speziellen pathologischen Anatomie und Histologie, Lubarsch, O., Henke, F., Roessle, R., Uehlinger, E. (eds.). Berlin: Springer-Verlag 1952
Witt, A.N., Cotta, H., Jaeger, M.: Die angeborenen Fehlbildungen der Hand und ihre operative Behandlung. Stuttgart: Thieme 1966
Wood, V.E., Flatt, A.E.: Congenital triangular bones in the hand. J. Hand Surg. 2, 179 (1977)
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ogden, J.A., Light, T.R. & Conlogue, G.J. Correlative roentgenography and morphology of the longitudinal epiphyseal bracket. Skeletal Radiol. 6, 109–117 (1981). https://doi.org/10.1007/BF00347572
Issue Date:
DOI: https://doi.org/10.1007/BF00347572