Summary
Longitudinal growth determined by roentgen stereophotogrammerry was registered in three patients with physial injuries in distal femur and in two patients with physial injuries in proximal tibia during 18 months. The injuries in distal femur were classified as Type I, Type I + III and Type IV and in proximal tibia as Type I + III and Type IV in the different cases according to Salter and Harris. Markers of tantalum balls were implanted into the metaphysis and bony epiphysis of distal femur and proximal tibia permitting regular determination of longitudinal growth.
Significant growth disturbances was registered in four patients. The Salter-Harris classification was difficult to use to predict growth disturbance after physial injuries around the knee.
The roentgen stereophotogrammetric method was found useful to determine normal growth rate and after physial injuries to reveal growth disturbance leading to complete or partial growth arrest resulting in leg length discrepancy or angular deformity. This method facilitates preoperative planning if surgery is needed.
Zusammenfassung
Über 18 Monate wurde mit Hilfe der Röntgenstereophotogrammetrie das Längenwachstum geschädigter Wachstumsfugen am distalen Femur (3 Fälle) sowie der proximalen Tibia (2 Fälle) verfolgt. Dabei handelte es sich am Femur um Schädigungstypen I, I + III und IV (nach Salter/Harris), an der Tibia um die Typen I + III und IV.
Um eine exakte Messung des Längenwachstums durchführen zu können, wurden Tantalkugeln als „Markören” sowohl in die Metaphyse als auch in die Epiphyse des distalen Femurs und der proximalen und distalen Tibia eingebracht. In vier Fällen waren signifikante Wachstumsstorungen zu registrieren, ohne daß aufgrund der Salter-Harris-Einteilung zu-vor eine abartige Wachstumsstörung zu erwarten gewesen wäre. - Die Röntgenstereophotogrammetrie kann somit nicht nur als Methode zur Bestimmung des normalen Wachstums angesehen werden, sondern ist gleichfalls geeignet, Wachstumsstorungen bei traumatisch bedingten Fugenschädigungen aufzuzeigen.
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Bylander, B., Aronson, S., Egund, N. et al. Growth disturbance after physial injury of distal femur and proximal tibia studied by roentgen stereophotogrammetry. Arch. Orth. Traum. Surg. 98, 225–235 (1981). https://doi.org/10.1007/BF00632981
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DOI: https://doi.org/10.1007/BF00632981