Alteration of Epiphyseal Growth by an Experimentally Produced Angular Deformity

Valgus Deformity following Proximal Tibial Metaphyseal Fracture in Children

“…The majority has been focused on the correction of the angulation at the fracture site, a correction which per se is fairly slight (Bennek & Steinert 1966, Hansen et al 1976. The above observations of corrective growth are in keeping with the results of animal experiments done by Ryoppy & Karaharju (1974), Karaharju et al (1976), and two clinical-radiological studies by . Their studies demonstrated correction by longitudinal growth owing to asymmetrical growth in the epiphyseal plates after healing with deformity of fractures of the shafts bowing in the distal metaphysis.…”

Remodelling After Distal Forearm Fractures in Children II:The Final Orientation of the Distal and Proximal Epiphyseal Plates of the Radius

“…This confirms that the epiphyseal plates react with a redistribution of growth after fracture healing with residual angulation (Friberg 1974, 1979, Ryoppy & Karaharju 1974, Karaharju et al 1976). Furthermore, it shows that this process in the forearm is capable of restoring an almost normal orientation of the epiphyseal plates.…”

“…This indicates that the orientation of the long axis of the bone is of importance for the final orientation of the distal epiphyseal plate and thus indirectly supports the suggestion that a biomechanical factor governs the process of normalization (Ryoppy & Karaharju 1974, Pauwels 1975 Hinrichsen & Storey 1968) has shown that alterations in the direction or amplitude of the normal forces acting on an epiphyseal plate are capable of influencing growth in the plate. The general results of these experiments show that an increase in pressure results in a reduced growth potential.…”

“…In experimental studies on the tibia of the rat and dog Ryoppy & Karaharju (1974) and Karaharju et al (1976) found that both the distal and the proximal epiphyseal plates changed their directions of growth after mid-diaphyseal fractures that had healed with residual angulation. In children, Friberg (1974children, Friberg ( , 1979 demonstrated that after a distal forearm fracture the distal epiphyseal plate of the radius shows a tendency towards spontaneous restoration of its normal orientation.…”

“…Residual angulation will induce a redistribution of growth at the epiphyseal plate (Ryoppy & Karaharju 1974). The redistribution of growth will subsequently lead to the normalization of an abnormal inclination of the epiphyseal plate.…”