骺板骨桥切除后骺板恢复开放的X线观察

X-ray monitor the growth plate after physeal bar excision

目的 观察儿童骺板骨桥切除术后 4年以上者骺板恢复纵向生长的时间、速率及骨骺和干骺端的变化。方法 采取临床和系列X线片观察和测量的方法 ,并与健侧对比 ,计算手术侧骺板年生长率、骨骺和干骺端的变化。结果 本组 4例平均随诊 5 .2年。术后 3例骺板恢复开放 ,从测量骺板线与骨桥切除后填塞脂肪的骨孔向干骺端移位的距离 ,发现肢体多在术后 4～ 6个月开始恢复生长 ,患肢比健肢年平均短缩约 0 .2cm ,其生长速率可达到正常侧的 90 %左右。其中 1例 4岁 3个月女童的股骨远端骺板中央型骨桥 ,术后患侧股骨年生长 2 .2 8cm ,健侧股骨年生长 2 .45cm ;患侧年生长率为健侧的 93%。结论 骨桥切除是治疗骺板部分早闭确实有效的方法 ,其生长速率可达到正常侧的 90 %左右。

Objective To study the longitudinal growth and epiphyseal and metaphyseal changes after excision of physeal bar in children with the partial growth plate arrest. Methods Physical and radiological assessment of epiphysis and metaphysis growth were carried out on patients who underwent physeal bar excision. The contralateral limbs were used as controls. Results Four patients who underwent physeal bar excision were followed-up for 4 to 5.8 years (mean, 5.2 years). In three of them, the growth plate opened up after the operation. The physeal longitudinal growth resumed 4～6 months after operation. The growth rate of operated bone was about 90% of that of the contralateral normal bone. A 4 years and three months old girl had central epiphyseal bar in left distal femoral growth plate excised 5.8 years ago. The left femoral growth was 2.28 *!cm whereas the right one was 2.45 *!cm per year after the operation. The growth rate in left femur was 93% of that of the right femur. Conclusion Excision of epiphyseal bar was effective treatment for the partial arrest of growth plate in children.