DESEPIPHYSIODESIS - ELIMINATION OF PARTIAL PREMATURE EPIPHYSEAL CLOSURE - EXPERIENCE OF 17 CASES

Between 1975 and 1990, 17 growth plates have been operated on by epiph yseal bridge resection. The children were from 4 years and 10 months t o 13 years and 10 months old. The etiology of partial closure was trau matic (10 times), caused by therapeutic mistakes (3 times), septic ost eomyelitis (1 case), purpura fulminans (1 case), unknown (2 cases). Th ere was always length discrepancy or deformity of bone. The regions th at have been subjected to treatment were distal femur, proximal tibia, distal tibia, distal radius. Evaluation of the bone bridge was made b y tomoscintigraphies and recently by MR imaging and computed tomoscint igraphy. The bone bridge size was from 2.5 % to 60 % of the growth pla te surface; surgical technique consists of resection of bone bridge co nnecting epiphysis and metaphysis which is replaced by methyl metacryl ate. In 16 cases simultaneous corrective osteotomy was performed. Resu lts are poor, there were only two good results and 8 failures; seven r esults were medium. The failures can all be explained by mistakes in t echnique or indication, except one. Indications are post-traumatic nar row bridges in young children. It would be useful to know the vitality of the residual growth plate.