BONE-GROWTH AFTER REPLANTATION IN CHILDREN

Bone growth and the development of epiphyseal plates are disturbed aft er the replantation of amputated extremities in children, but the pote ntial for continued skeletal growth is almost always maintained in the replanted part. In this reported series of 12 children, all younger t han 15 years old, 13 amputated parts of the upper limb have been succe ssfully replanted. After long-term follow-up (from 21 to 216 months), bone growth of the replanted parts was clinically and radiologically e valuated. Two different growing segments were distinguished: the proxi mal bone segment, directly injured from the initial trauma, and the di stal replanted part. Average longitudinal growth recorded was 94.5 per cent and 92.7 percent, respectively. Two young patients demonstrated o vergrowth of the proximal bone segment, which attained 110 percent and 118 percent of expected growth. Although it is difficult to determine all the parameters affecting the prognosis of post-traumatic reaction s in growing cartilaginous plates, the level of amputation is consider ed to be a significant prognostic factor for the epiphyseal growth of the replanted part.